US8328837B2 - Method and apparatus for performing needle guided interventions - Google Patents

Method and apparatus for performing needle guided interventions Download PDF

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Publication number
US8328837B2
US8328837B2 US11/886,499 US88649905A US8328837B2 US 8328837 B2 US8328837 B2 US 8328837B2 US 88649905 A US88649905 A US 88649905A US 8328837 B2 US8328837 B2 US 8328837B2
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Prior art keywords
needle
catheter device
actuator
endoscope
catheter
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US11/886,499
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US20090030380A1 (en
Inventor
Kenneth Binmoeller
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Boston Scientific Scimed Inc
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XLumena Inc
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Publication of US20090030380A1 publication Critical patent/US20090030380A1/en
Assigned to VENTURE LENDING & LEASING VI, INC., VENTURE LENDING & LEASING V, INC. reassignment VENTURE LENDING & LEASING VI, INC. SECURITY AGREEMENT Assignors: XLUMENA, INC.
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Assigned to XLUMENA, INC. reassignment XLUMENA, INC. RELEASE BY SECURED PARTY (SEE DOCUMENT FOR DETAILS). Assignors: VENTURE LENDING & LEASING V, INC., VENTURE LENDING & LEASING VI, INC.
Assigned to BOSTON SCIENTIFIC SCIMED, INC. reassignment BOSTON SCIENTIFIC SCIMED, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: XLUMENA, INC.
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M29/00Dilators with or without means for introducing media, e.g. remedies
    • A61M29/02Dilators made of swellable material
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/018Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131Accessories for endoscopes
    • A61B1/00133Drive units for endoscopic tools inserted through or with the endoscope
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3478Endoscopic needles, e.g. for infusion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M25/104Balloon catheters used for angioplasty
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238Type of minimally invasive operation
    • A61B2017/00278Transorgan operations, e.g. transgastric
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/0034Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743Type of operation; Specification of treatment sites
    • A61B2017/00818Treatment of the gastro-intestinal system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/0067Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0082Catheter tip comprising a tool
    • A61M25/0084Catheter tip comprising a tool being one or more injection needles
    • A61M2025/0089Single injection needle protruding axially, i.e. along the longitudinal axis of the catheter, from the distal tip
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1079Balloon catheters with special features or adapted for special applications having radio-opaque markers in the region of the balloon
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/0067Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0082Catheter tip comprising a tool
    • A61M25/0084Catheter tip comprising a tool being one or more injection needles

Definitions

  • Disclosed is a device and method for performing needle guided interventions and especially needle guided dilations of tissue to create a therapeutic conduit between two luminal organs or structures.
  • the device is particularly useful for creation of an artificial lumen between hollow body organs using the working lumen of an endoscope.
  • a luminal passageway between two lumen containing organs in the body. Examples of these would be between a segment of bowel and another structure such as another section of bowel, gallbladder, bile or pancreatic duct. Often the second luminal structure is not an organ but rather a cyst, pseudocyst or abscess.
  • a conduit between a bowel lumen (stomach, colon, rectum or duodenum) and a luminal structure is performed using an ultrasound endoscope.
  • a stylet-filled continuous stainless steel needle is advanced through the working lumen of an ultrasound endoscope and directed through the wall of the bowel and into the targeted luminal structure lying adjacent to the bowel.
  • Once inside the structure the stylet is removed and a guidewire is advanced into the luminal structure.
  • the needle is removed and a catheter device is advanced over the guidewire and directed through the bowel wall into the luminal structure. Examples of catheter devices are dilating bougie catheters and balloon catheters.
  • a stylet-filled continuous stainless steel needle is advanced through the working lumen of an endoscope and directed through the wall of the bowel and into a pseudocyst cavity lying adjacent to the bowel.
  • a guidewire is advanced through the needle and into the pseudocyst.
  • the needle is removed and a balloon catheter is advanced over the guidewire and directed through the bowel wall until the deflated balloon lies across the wall of the bowel and the tissue interposed between the bowel and the pseudocyst.
  • the balloon is then inflated creating a 6-8 mm passageway between the bowel and the pseudocyst cavity.
  • the balloon is deflated and the catheter removed over the guidewire leaving behind an enlarged conduit.
  • a double pigtailed drainage catheter or other drainage device is then advanced over the guidewire and one end is placed inside the pseudocyst cavity and the other inside the bowel thus facilitating the drainage of fluid from the pseudocyst into the bowel.
  • a stylet-filled continuous stainless steel needle is advanced through the working lumen of an ultrasound endoscope and directed into the bile or pancreatic duct upstream from the site of obstruction.
  • the stylet is removed and a guidewire is advanced through the needle and into the duct.
  • the needle is removed and a dilating catheter or balloon catheter is advanced over the guidewire and directed into the duct.
  • a stent is then advanced over the guidewire and one end is placed inside the duct and the other inside the bowel.
  • the procedures as described above are often difficult to complete successfully because once the needle is removed, the remaining guidewire lacks the rigidity to provide adequate support for the catheter device. This makes it difficult to push the catheter device through the bowel wall and into the luminal structure. This is particularly true when the tissue interposed between the bowel lumen and the targeted luminal structure is thick, edematous or fibrotic. Often the catheter device will simply buckle inside the bowel and not advance through the wall. Furthermore, the small diameter guidewire has a tendency to dislodge during the exchange of the needle for the balloon catheter which causes a loss of lumen access and necessitates repeating the procedure.
  • the present invention is directed to an apparatus and method that as embodied and broadly described herein, includes a handle, a catheter device, a needle, actuators and locking members that integrate the control and movement of a catheter and a needle that are used for creation of an artificial lumen between organs, hollow bodies or two segments of bowel using the working lumen of an endoscope.
  • the catheter device is provided with at least one inner lumen and the needle is positioned inside the catheter device and is used to facilitate the initial puncture of the tissue and provide support so that the catheter device can be advanced over the needle and across the tissue passageway formed by the needle.
  • the handle incorporates actuators that are attached to the catheter device and needle and are used to advance and retract the catheter device and the puncture needle along the axis of the endoscope. Locking members are provided that fix the position of the catheter device or needle relative to the endoscope.
  • the present invention includes a method of forming a passageway in the wall of a hollow body organ by placing an apparatus into the working lumen of an endoscope and coupling the device to the proximal end of the endoscope.
  • the needle is advanced by moving the actuator which is coupled to the proximal end of the needle. Once in position across the tissue wall, the needle can be fixed to the endoscope by using a locking member.
  • the catheter device can be advanced over the needle by moving the actuator which is coupled to the proximal end of the apparatus.
  • the catheter device can advance over the needle to cross the tissue wall.
  • the catheter device may also contain a balloon that is useful for forming a larger passageway.
  • FIG. 1 is a system view of one embodiment of the apparatus
  • FIG. 2 is an exploded assembly view of the apparatus
  • FIG. 3 is section view of the proximal end of the needle actuator showing the needle and stylet;
  • FIG. 4 is a view of the catheter device actuator
  • FIG. 5 is a section view of the catheter device actuator
  • FIG. 6 is a section view of the assembled catheter device and needle actuators
  • FIG. 7 is a view of the handle without the catheter device or needle actuators
  • FIG. 8 is a cross sectional view of the handle body taken through the locking groove with the catheter device actuator removed;
  • FIG. 9 is a cross sectional view of the handle body taken through the locking ramp with the catheter device actuator removed;
  • FIG. 10 is a cutaway side view of the handle body showing the locking ramp with the needle and catheter device actuators removed;
  • FIG. 11 is a system view of another embodiment of the apparatus.
  • FIG. 12 is an exploded assembly view of the apparatus of FIG. 11 ;
  • FIG. 13 is view of the needle actuator of FIG. 1 ;
  • FIG. 14 is section view of the catheter actuator of FIG. 11 ;
  • FIG. 15 is a section view of the assembled catheter device and needle actuators
  • FIG. 16A is a cross sectional view of the catheter actuator taken through the holder and inflation port (A-A) with the needle actuator removed;
  • FIG. 16B is a cross sectional view of the catheter actuator taken through the holder and inflation port (A-A) including the needle actuator and stylet;
  • FIG. 16C is a cross sectional view of an alternate embodiment of the catheter actuator taken through the inflation port (A-A) with the needle actuator removed;
  • FIG. 17 is a view of the distal portion of the apparatus loaded into the working channel of an endoscope and adjacent to a tissue wall;
  • FIG. 18 is a view similar to FIG. 11 showing the needle across the tissue
  • FIG. 19 is a view similar to FIG. 12 showing the catheter device across the tissue with the dilation balloon deflated;
  • FIG. 20 is a view similar to FIG. 13 showing the needle removed and a guidewire positioned across the tissue;
  • FIG. 21 is a view similar to FIG. 14 showing the catheter device with access to a duct and the guidewire positioned in the duct.
  • the apparatus and method described herein may offer improvements over the techniques currently utilized to perform endoscopy or endosonography guided transluminal creation of therapeutic passageways.
  • the apparatus performs the same result as the current medical practice described but utilizes fewer parts, requires fewer instrument exchanges and provides a more stable and solid platform for performing punctures and therapeutic interventions such as tissue dilation.
  • the apparatus 10 utilizes a handle 15 , a catheter device actuator 20 and a needle actuator 22 along with a catheter device 24 and a 22 or 23 gauge hollow sharpened needle 26 .
  • a stylet 28 which fills the inner lumen of the needle in a similar manner to other over-the-wire puncture needles.
  • the continuous stainless steel needle is stiffer than a guidewire and provides excellent support for the coaxial advancement of catheter devices over the needle 26 .
  • the handle 15 is designed to be held by a physician to support the apparatus 10 in one hand while the catheter device actuator 20 or the needle actuator 22 or both are manipulated.
  • the catheter device actuator 20 may function independently from the needle actuator 22 .
  • the movement of the needle actuator 22 may be described, it is anticipated that the catheter device 24 may also be simultaneously operated or sequentially operated according to the medical procedure being performed.
  • the needle actuator 22 and the catheter device actuator 20 may be operated together as a single unit if required. No inference as to order, sequence or dependence of the catheter device or needle movement on the other is intended.
  • the handle 15 is particularly useful in integrating the control of the movement of the coaxial system of catheter device 24 and needle 26 into a single location.
  • the actuators for both the catheter device 24 and needle 26 make up a part of the handle. The operator can move the catheter device 24 and needle 26 from these actuators which can make a previously cumbersome procedure easier, less confusing and faster.
  • the handle 15 has a body 30 that is a hollow cylindrical tube that is open at the proximal end 31 .
  • the distal end 33 is essentially closed except for a single opening that is sized for the catheter device to pass through.
  • the body 30 functions as a housing for the catheter device and needle actuators and can be constructed from plastic or metal.
  • the body 30 is threaded at the proximal end 31 with threads 34 designed to mate with a cap 32 .
  • the cap 32 is designed to screw onto the body 30 and partially close the proximal end 31 of the body 30 .
  • the body has one or more slits 36 running parallel to the body axis and perpendicular to the threads 34 .
  • These slits 36 intersect the threads 34 and are designed to function as a compression joint as the cap 32 is threaded onto the body.
  • the cap 32 reduces the effective inside diameter of the body at the proximal end 31 . This diameter reduction has the effect of clamping down onto the catheter device actuator 20 that is positioned inside the body and acting as a locking member.
  • the endoscope 100 shown in FIG. 11 is an important part of the function of the apparatus 10 .
  • the apparatus 10 can function without an endoscope but the endoscope can make the performance and accordingly the success of the procedure greater.
  • the endoscope body provides support to the catheter device as the distal portion of the catheter device is passed out of the endoscope tip. In order to push a needle across a tissue wall, often considerable force is required.
  • the inner walls of the endoscope 100 support the catheter device 24 so that a thrust of the needle 26 is translated into a forward thrust of the needle tip 58 across a tissue wall. This is best accomplished if the catheter device 24 and the endoscope 100 are coupled.
  • a forward movement of the catheter device 24 is expressed as a forward movement of the catheter device distal end and not a corresponding backward movement of the endoscope 100 .
  • One of the functions of the handle 15 is to join with the endoscope 100 so that any movement of the catheter device 24 or needle 26 does not cause a reverse movement of the endoscope 100 at the same time.
  • a connector 38 that mates with a corresponding connector on the endoscope body.
  • the connector 38 is commonly known as a luer connector and mates to a corresponding luer connector found on the proximal end of most endoscopes.
  • the needle actuator 22 is sized to be placed into the inner diameter of the catheter device actuator 20 .
  • the catheter device actuator 20 is sized to be placed into the inner diameter of the body 30 .
  • the catheter device and needle actuators and the body 30 function together as a combined mechanism. As will be shown this mechanism allows for the independent movement of the catheter device 24 and the needle 26 relative to each other and the endoscope 100 .
  • the needle actuator 22 is shown in a section view.
  • the needle actuator is a hollow cylindrical tube 50 with a proximal 52 and distal 54 end.
  • the tube 50 is joined with a hollow needle 26 at the distal end 54 and has a small opening at the proximal end 52 to receive a stylet 56 .
  • the needle 26 has a sharpened end 58 that is suitable for puncturing tissue and may have an inner diameter sized to receive a stylet 56 .
  • a stylet 56 is shown in FIG. 3 , the inclusion of a stylet 56 is not required.
  • the stylet shown has an end plug 59 at the proximal end and a generally rounded tip 60 at the distal end.
  • the tube 50 also has a locking tab 62 located toward the distal end 54 of its outside diameter. This locking tab 62 is used to fix the movement of the needle actuator 22 relative the endoscope 100 .
  • the tab 62 is designed to mate with a locking groove 45 located on the inner diameter of the handle body 30 .
  • the catheter device actuator 20 is shown in greater detail in FIGS. 4-6 .
  • the catheter device actuator 20 controls the movement of the catheter device 24 and can move the catheter device 24 along the central axis of the endoscope.
  • the catheter device actuator 20 has a housing 70 as shown in FIG. 4 .
  • the housing 70 is a hollow cylindrical tube that has a distal end and a proximal end. The distal end tapers slightly to join with the sheath 24 .
  • the body has a longitudinal slot 72 that is sized to accept the locking tab 62 of the needle body tube 50 .
  • the slot 72 is continuous from the proximal end of the housing 70 to approximately three quarters of the distance to the distal end of the housing 70 .
  • the proximal end of the body has threads 73 to accept the threads of the end cap 75 .
  • the end cap 75 prevents the needle actuator which is positioned inside the hollow interior of the housing 70 from coming out of the housing 70 . However, the end cap 75 may be removed so that the needle actuator can be withdrawn from the tissue dilator if desired.
  • the cap has a round hole at its center that allows the proximal portion 52 of the needle actuator 22 and the stylet 28 to extend outside the housing 70 .
  • the catheter device 24 has two inner lumens that extend from the distal end to the proximal end.
  • This catheter device 24 may be constructed from various materials such as plastic polymers, spring coils, silicone or Teflon tubing.
  • the main lumen 77 is the larger and is designed to accept the needle body 26 and is also large enough to accommodate one 0.035′′ or up to two 0.021′′ guidewires when the needle is removed.
  • the smaller lumen 76 is for inflating and deflating a dilation balloon attached to the distal end of the catheter device.
  • the end of the dilation balloon 25 can be located immediately adjacent to the catheter device end 21 . More preferably the distal end of the balloon can be located between the distal end of the catheter device 24 and up to 4 cm from the distal end of the catheter device.
  • the balloon 25 has a preferred inflated diameter of between 5 and 10 mm and an effective balloon length of 3-6 cm. However various balloon lengths and diameters could be used.
  • the catheter device may also be constructed without a dilation balloon in which case the catheter device 24 would have a single lumen and no inflation port.
  • the catheter device actuator 20 has two lumens corresponding to lumens of the sheath. As shown in FIG. 5 , the needle lumen 79 is continuous the entire length of the housing 70 . It is connected to the main lumen 77 of the sheath.
  • the inflation lumen 78 extends from the distal end of the housing 70 and is terminated before the proximal end of the housing 70 . This lumen communicates with the smaller lumen 76 of the sheath.
  • the housing 70 has an inflation port 83 that is attached to the catheter device actuator and has a luer connector 84 at the outside end suitable for mating with an inflation syringe.
  • the inflation port 83 is used to inflate and deflate the balloon 25 .
  • the proximal portion of the inflation lumen 78 is blocked with a plug 81 to prevent leakage of dilation fluid out the proximal end of the inflation lumen 78 .
  • the needle actuator 22 and the catheter device actuator 20 are assembled together in FIG. 6 .
  • the needle actuator 22 is positioned inside the catheter device actuator 20 .
  • the locking tab 62 which is positioned in the slot 72 and protrudes through the wall of the housing 70 .
  • the end cap 75 which retains the needle actuator inside the hollow housing 70 .
  • the handle body is shown in greater detail in FIG. 7 .
  • the cylindrical body 30 has an opening 40 in the main body. This opening is located in the central portion of the body and is open to the inside of the body 30 .
  • the opening 40 is formed in the body 30 to accept the inflation port 83 of the catheter device actuator.
  • the catheter device actuator 20 slides along the inner diameter of the body 30 and the opening provides clearance for the inflation port 83 so that the catheter device actuator 20 can be advanced, retracted and slightly rotated inside the body 30 .
  • the surface of the inside wall of the body has a locking groove 45 that is used to interface with the locking tab 62 of the needle actuator 22 .
  • the groove 45 is continuous from the proximal end of the body 30 to approximately three fourths of the distance to the distal portion of the body.
  • the outer diameter “x” of the needle actuator tube 50 at the locking tab 62 is slightly less than the inner diameter “y” of the cylindrical body 30 measured at the groove as shown in the cross sectional view of the handle body and needle actuator in FIG. 8 .
  • the sheath actuator has been removed for clarity.
  • the depth of the groove 45 is such that the locking tab 62 has clearance to move freely but not enough clearance to jump out of the groove 45 .
  • the locking tab 62 slides in the groove of the body 30 as the needle actuator 22 is advanced and retracted inside the catheter device activator 20 .
  • the groove is interrupted along its length by a locking ramp 47 .
  • the locking ramp 47 shown greater detail in FIGS. 9-10 , is located along the groove 45 .
  • the depth of the locking ramp 47 varies in a radial direction. At the entrance to the locking ramp 47 at the groove 45 , the depth of the locking ramp 47 is the same as the bottom of the groove 45 but the side wall gradually slopes to meet the inside diameter of the handle body 30 .
  • the locking tab 62 is advanced and retracted along the groove 45 , if the needle actuator body 22 is slightly rotated, the locking tab moves from the locking groove 45 and will travel onto the locking ramp 47 .
  • the locking ramp 47 restricts the free movement of the locking tab 62 along the longitudinal axis of the endoscope 100 .
  • the locking tab 62 will travel along the tapering side wall and impinge upon the tapering side wall so that forward travel will eventually be stopped as the clearance is eliminated. At this point the locking tab 62 will remain essentially fixed with regard to the central axis of the endoscope. In this position tab 62 acts as a locking member. If the needle actuator body 22 is rotated even further, the locking tab 62 will continue to travel along the tapering side wall and will wedge itself along the side wall with a hard stop. In this way it is possible for the operator to lock the lateral movement of the needle actuator 22 relative to the endoscope 100 while still permitting movement of the catheter device actuator 20 . The operator also has control as to the degree of resistance felt. A slight rotation increases frictional drag but the needle actuator body 22 can still be moved along the endoscope axis. Further rotation increases drag even further until the needle activator body 22 is fixed.
  • the assembled apparatus is shown in FIG. 1 shows how the various parts are assembled together.
  • the arrows show the directions that the actuators may travel.
  • the needle actuator 22 can be advanced or retracted along the longitudinal axis of the endoscope according to arrow B as required which transmits the same movement to the needle inside the hollow body organ.
  • the needle actuator preferably can travel less than 10 cm.
  • the needle actuator can more preferably travel between 4 and 8 cm.
  • the catheter device actuator 20 can be advanced or retracted along the longitudinal axis of the endoscope according to arrow A as required which transmits the same movement to the catheter device 24 inside the hollow body organ or structure.
  • the catheter device actuator 20 preferably can travel less than 10 cm.
  • the catheter device actuator 20 can more preferably travel between 4 and 8 cm.
  • the movement of either actuator can also be locked with respect to the endoscope while permitting movement of the other actuator.
  • the needle actuator 20 is locked by rotating it according to C as required which moves the locking tab 62 along the locking ramp 47 .
  • the catheter actuator 22 is locked in position by screwing down the cap 32 located at the proximal end 31 of the handle body 30 .
  • This apparatus permits the operator to easily control the location and movement of both the needle 26 and catheter device 24 . In this way the needle 26 can be advanced first, its position fixed and then the catheter device 24 can be advanced over the needle 26 without concern that the needle 26 will travel further into the tissue at the same time. This might provide for a safer and easier procedure.
  • FIG. 11 An alternative embodiment of the apparatus 10 is shown in FIG. 11 .
  • the apparatus 10 utilizes a handle 115 , a catheter actuator 120 and a needle actuator 122 along with a catheter device 24 and a 22 or 23 gauge hollow sharpened needle 26 .
  • a stylet 28 can fill the inner lumen of the needle 26 .
  • the handle 115 is designed to be held by a physician to support the apparatus 10 while the catheter actuator 120 or the needle actuator 122 or both are manipulated.
  • the catheter device 24 and the needle 26 of this embodiment may function as a single unit or independently from each other. That is the catheter actuator 120 and the needle actuator 122 may be simultaneously or sequentially operated.
  • the handle 115 is particularly useful in integrating the control of the movement of the coaxial system of catheter device 24 and needle 26 into a single location.
  • the actuators for both the catheter device 24 and needle 26 make up a part of the handle 115 . The operator can move the catheter device 24 and needle 26 from these actuators.
  • the handle 115 has a body 130 that is a hollow cylindrical tube that is manufactured with the proximal end 131 open.
  • the distal end 133 is essentially closed except for a single opening that is sized for the catheter device to pass through.
  • the body 130 functions as a housing for the catheter device and needle actuators and can be constructed from plastic, metal or other suitable material.
  • the body 130 is threaded at the proximal end 131 with threads 134 designed to mate with a cap 132 .
  • the cap 132 is designed to screw onto the body 130 and partially close the proximal end 131 of the body 130 .
  • the body has one or more slits 136 running parallel to the body axis and perpendicular to the threads 134 .
  • These slits 136 intersect the threads 134 and are designed to function as a compression joint as the cap 132 is threaded onto the body.
  • the cap 132 reduces the effective inside diameter of the body at the proximal end 131 to act as a locking member to clamp down onto the needle actuator 122 .
  • the handle 115 couples with the endoscope 100 so that any movement of the catheter device 24 or needle 26 does not cause a reverse movement of the endoscope 100 at the same time.
  • a connector 138 at the distal end of the handle 133 mates with a corresponding connector on the endoscope body.
  • the connector 138 is preferably a luer connector but any connector that can couple the handle and endoscope together is acceptable.
  • the needle 26 is sized to slide inside the needle actuator 122 and inside the inner diameter of the catheter device 24 .
  • the proximal end of the needle 26 has a hub 138 that is attached to the needle and the hub 138 is designed to couple with a corresponding connector 139 on the proximal end of the needle actuator 122 .
  • This hub 138 facilitates the attachment of the needle to the needle actuator 122 for movement of the needle by the actuator.
  • the hub 138 can be disconnected from the connector 139 and the needle actuator 122 to remove the needle 26 from the needle actuator 122 and the body 130 .
  • the needle actuator 122 is sized to slide over the outside of the catheter actuator 120 and then inside the inner diameter of the body 130 .
  • the catheter and needle actuators and the body 130 function together as a combined mechanism.
  • the needle actuator 122 is shown in greater detail in FIG. 13 .
  • the needle actuator 122 is a hollow cylindrical tube 150 .
  • the distal end is open and the proximal end terminates at the connector 139 .
  • the inside diameter of the needle actuator 122 is sized to fit along the outside diameter of the catheter actuator 120 . Generally the dimensions of the two diameters are close to one another so that the catheter actuator 120 can travel inside the tube 150 freely but the travel should be smooth and without unusual wobble.
  • the tube 150 has one or more slits 151 that run longitudinally along the major length of the tube 150 . The slits are continuous from the outside diameter of the tube 150 through the wall of the tube 150 to the inside diameter. If more than one slit is utilized, the slits 151 should be symmetrically arranged around the circumference of the tube 150 .
  • the smaller lumen 76 can be used for inflating and deflating a dilation balloon 25 attached to the distal end of the catheter device 24 .
  • the catheter device 24 may also be constructed without a dilation balloon in which case the catheter device 24 would have a single lumen and no inflation port.
  • the inflation lumen 168 is in fluid communication with the smaller lumen 76 of the catheter device 24 and the inflation port 164 of the catheter actuator 120 .
  • the inflation port 164 has a luer connector 166 at the outside end suitable for attaching to an inflation syringe.
  • the inflation port 164 is used to inflate and deflate the balloon 25 .
  • the proximal portion of the lumen 168 is blocked with a plug 170 to prevent leakage of dilation fluid out the proximal end of the inflation lumen 168 .
  • the needle lumen 169 connected to the larger lumen 77 of the catheter device 24 and is open at both ends to receive the needle 26 .
  • the holder 162 is coupled to the housing 160 and is used by the operator to advance and retract the catheter actuator 120 along the handle 115 .
  • the holder 162 is long enough to extend through the needle actuator body 150 and the handle 115 .
  • a holder 162 and an inflation port 164 are shown, it is possible to combine the functions of these into one device.
  • the inflation port 164 would serve as fluid injection site and as a holder so that the operator could use it to manipulate the catheter actuator.
  • This embodiment would eliminate the holder 162 and would require only one slit 151 in the tube 150 .
  • This embodiment may be simpler to operate and less expensive.
  • the proximal end 171 of the housing may be lengthened as necessary to insure that some part of the housing is always secure inside the body 115 when the catheter actuator is advanced.
  • the housing is sized to fit snugly inside the needle actuator body 122 .
  • FIG. 15 The catheter actuator 120 and the needle actuator 122 are assembled together in FIG. 15 .
  • the needle actuator 122 is positioned outside the catheter actuator 120 but the needle 26 is positioned inside the catheter actuator 120 .
  • the holder 162 and the inflation port 164 are shown extending through the slits 151 of the needle actuator 122 .
  • FIG. 16A shows a cross section of the catheter actuator 120 taken along section A-A with the needle actuator 122 removed.
  • FIG. 16B shows a cross section of the same catheter actuator 120 taken along section A-A with the needle actuator 122 in place.
  • the slits 151 are shown with the holder 162 and inflation port 164 extending through these slits.
  • the needle 26 and stylet 28 are shown in the center of lumen 169 .
  • FIG. 16C shows a cross section of the same catheter actuator 120 taken along section A-A with the needle actuator 122 and the holder 162 removed.
  • the inflation port 164 functions as an inflation fluid introduction site and as a holder.
  • the holder 162 and inflation port 164 move in a distal direction along their respective openings in the body 115 .
  • the holder 162 and inflation port 164 can be radially rotated slightly so that the holder and inflation port move into one of these locking members 182 that are sized to accept the holder 162 and the inflation port 164 .
  • Once the holder 162 and inflation port 164 are positioned in the locking member 182 their distal movement along the body 115 is prevented. In this way the operator can advance the catheter device 24 until the tip is positioned correctly in the body and then lock the position of the catheter device 24 relative to the endoscope 100 .
  • the assembled apparatus is shown in FIG. 11 and this figure illustrates how the various parts are assembled together.
  • the arrows show the directions that the actuators travel.
  • the needle 26 and stylet 28 can be moved in the directions D as shown.
  • the needle 26 and the needle actuator 122 can be moved like a single unit along the inside walls of the body 115 in the directions E. This is accomplished by grasping the connector 139 or the outside of the actuator body and moving it distally while holding the handle 115 .
  • the catheter actuator 120 can be advanced along the inside walls of the needle actuator 122 by using the holder 162 in the directions F as shown.
  • a slight rotational movement, not shown, applied to the holder 162 or the inflation port 164 causes these to move into any one of a number of locking slots 182 located along the edge of the slots.
  • the needle actuator 122 preferably can travel less than 10 cm.
  • the needle actuator 122 can more preferably travel between 4 and 8 cm.
  • the catheter device actuator 120 preferably can travel less than 10 cm.
  • the catheter device actuator 120 can more preferably travel between 4 and 8 cm.
  • the movement of either actuator can also be locked with respect to the endoscope.
  • the movement of the needle actuator 122 can be fixed to the endoscope by tightening the cap 32 . This causes the inside diameter of the body 115 to be reduced which impinges on the hollow cylindrical tube 150 of the needle actuator 122 .
  • the movement of the catheter actuator 120 can be fixed to the endoscope by rotating the holder 162 into one of the locking slots previously described.
  • the creation of a conduit between a bowel lumen 104 and a targeted luminal structure 102 can be performed using this system.
  • the stylet filled needle 26 and catheter device 24 are part of the apparatus that is introduced into the working lumen of an endoscope 100 .
  • the handle 15 is secured to the outer part of the endoscope working channel using the connector 38 .
  • the needle 26 is advanced up to 8 cm and passed through the wall of the bowel and into the targeted luminal structure as shown in FIG. 20 .
  • the stylet 28 can be removed and aspiration applied or contrast medium injected under fluoroscopy to confirm entry into the target lumen.
  • the target location shown in FIGS. 17-19 is a pseudocyst cavity 102 on the other side of the stomach wall 104 but the method may include many other target sites within the human body.
  • the needle 26 is then locked in position by rotating the needle actuator 22 until the locking tab 62 moves into a locking ramp 47 and the needle actuator 22 is fixed.
  • the catheter device 24 is next advanced along the stiff needle and through the tissue wall.
  • the position of the catheter device 24 relative to the targeted lumen can be determined by visualizing the radiopaque marker(s) 96 and 97 using fluoroscopy or by injecting radiopaque dye into the proximal end of the needle with the stylet removed.
  • the radiopaque markers 96 and 98 are located on each end of the dilating balloon.
  • the catheter device 24 can be locked in position by screwing down the cap 32 of the handle body 30 .
  • the balloon may be inflated using the inflation port 83 with either liquid or gas inflation fluid.
  • the inflated balloon can create a passageway between the bowel and the target organ.
  • the inflated balloon 25 also serves to anchor the sheath 24 in position so that the needle 26 can be exchanged for a guidewire.
  • the needle 26 can be withdrawn so that one 0.035′′ or two 0.021′′ guidewires can be introduced through the catheter device 24 and into the target lumen.
  • the balloon 25 is deflated and the catheter device 24 can be removed over the guidewire(s) leaving behind an enlarged conduit with at least one guidewire across.
  • the device can function as an anchoring catheter to facilitate the placement of a guidewire into a lumen.
  • this procedure can be used to place a guidewire into a body duct 99 as shown in FIG. 21 .
  • the duct is preferably a bile or pancreatic duct.
  • the needle 26 is advanced under endoscopic ultrasound guidance from the duodenum or stomach through the bowel wall and into the bile or pancreatic duct using the sharpened needle tip.
  • the catheter device 24 is then advanced over the needle 26 and into the duct 99 .
  • the dilating balloon 25 can be optionally inflated.
  • a pre-curved or steerable-tipped catheter can be positioned over the stylet filled needle instead of the balloon device.
  • the curved catheter tip is useful to steer the catheter tip in different directions.
  • this procedure can be used to place a guidewire into the bile or pancreatic ducts from an anterograde position.
  • the needle 26 is advanced under endoscopic ultrasound guidance from the duodenum or stomach through the bowel wall and into the bile or pancreatic duct using the sharpened needle tip.
  • a catheter is then advanced over the needle and into the duct.
  • the needle is then exchanged for a 0.035′′ guidewire.

Abstract

An apparatus and method for performing needle guided interventions and especially needle guided dilations of tissue to create a therapeutic conduit between two luminal organs or structures. The device is particularly useful for creation of an artificial lumen between two hollow body organs using the working lumen of an endoscope.

Description

PRIORITY INFORMATION
This application claims priority to U.S. Provisional Application No. 60/634,254 filed on Dec. 8, 2004, the entire contents of which are hereby expressly incorporated by reference.
BACKGROUND OF THE INVENTION
1. Field of the Invention
Disclosed is a device and method for performing needle guided interventions and especially needle guided dilations of tissue to create a therapeutic conduit between two luminal organs or structures. The device is particularly useful for creation of an artificial lumen between hollow body organs using the working lumen of an endoscope.
2. Description of the Related Art
Often there is a need to create a luminal passageway between two lumen containing organs in the body. Examples of these would be between a segment of bowel and another structure such as another section of bowel, gallbladder, bile or pancreatic duct. Often the second luminal structure is not an organ but rather a cyst, pseudocyst or abscess.
Other techniques and devices exist to perform these procedures. The creation of a conduit between a bowel lumen (stomach, colon, rectum or duodenum) and a luminal structure is performed using an ultrasound endoscope. A stylet-filled continuous stainless steel needle is advanced through the working lumen of an ultrasound endoscope and directed through the wall of the bowel and into the targeted luminal structure lying adjacent to the bowel. Once inside the structure the stylet is removed and a guidewire is advanced into the luminal structure. The needle is removed and a catheter device is advanced over the guidewire and directed through the bowel wall into the luminal structure. Examples of catheter devices are dilating bougie catheters and balloon catheters.
One example of how these procedures are typically performed is the drainage of fluid from a pseudocyst. In this procedure a stylet-filled continuous stainless steel needle is advanced through the working lumen of an endoscope and directed through the wall of the bowel and into a pseudocyst cavity lying adjacent to the bowel. Once inside the cavity, the stylet is removed and a guidewire is advanced through the needle and into the pseudocyst. The needle is removed and a balloon catheter is advanced over the guidewire and directed through the bowel wall until the deflated balloon lies across the wall of the bowel and the tissue interposed between the bowel and the pseudocyst. The balloon is then inflated creating a 6-8 mm passageway between the bowel and the pseudocyst cavity. The balloon is deflated and the catheter removed over the guidewire leaving behind an enlarged conduit. A double pigtailed drainage catheter or other drainage device is then advanced over the guidewire and one end is placed inside the pseudocyst cavity and the other inside the bowel thus facilitating the drainage of fluid from the pseudocyst into the bowel.
Another example of how these procedures are typically performed is the creation of a conduit between an obstructed bile or pancreatic duct and a bowel lumen using an ultrasound endoscope. A stylet-filled continuous stainless steel needle is advanced through the working lumen of an ultrasound endoscope and directed into the bile or pancreatic duct upstream from the site of obstruction. Once inside the duct, the stylet is removed and a guidewire is advanced through the needle and into the duct. The needle is removed and a dilating catheter or balloon catheter is advanced over the guidewire and directed into the duct. A stent is then advanced over the guidewire and one end is placed inside the duct and the other inside the bowel.
However the procedures as described above are often difficult to complete successfully because once the needle is removed, the remaining guidewire lacks the rigidity to provide adequate support for the catheter device. This makes it difficult to push the catheter device through the bowel wall and into the luminal structure. This is particularly true when the tissue interposed between the bowel lumen and the targeted luminal structure is thick, edematous or fibrotic. Often the catheter device will simply buckle inside the bowel and not advance through the wall. Furthermore, the small diameter guidewire has a tendency to dislodge during the exchange of the needle for the balloon catheter which causes a loss of lumen access and necessitates repeating the procedure. Even when successful, the physician is required to make many exchanges of the needle, guidewire and or catheters which can make the technique cumbersome and time consuming. A simpler procedure is necessary to overcome the disadvantages of current practice. Particularly, a system that will enable rapid catheter device access on the initial attempt after needle puncture of the target luminal structure and one that does not require multiple exchanges of accessories is needed. Also needed is a method of fixing the position of the needle and catheter device sheath relative to the endoscope while one or the other is advanced or retracted. Particularly, providing a more stable platform over which a catheter device sheath may be advanced is important and incorporating all the wires, sheaths and needles into a single integrated system would save the practitioner valuable time and reduce the chance of potential surgical morbidity.
BRIEF SUMMARY OF THE INVENTION
Accordingly the present invention is directed to an apparatus and method that as embodied and broadly described herein, includes a handle, a catheter device, a needle, actuators and locking members that integrate the control and movement of a catheter and a needle that are used for creation of an artificial lumen between organs, hollow bodies or two segments of bowel using the working lumen of an endoscope.
The catheter device is provided with at least one inner lumen and the needle is positioned inside the catheter device and is used to facilitate the initial puncture of the tissue and provide support so that the catheter device can be advanced over the needle and across the tissue passageway formed by the needle. The handle incorporates actuators that are attached to the catheter device and needle and are used to advance and retract the catheter device and the puncture needle along the axis of the endoscope. Locking members are provided that fix the position of the catheter device or needle relative to the endoscope.
In another aspect the present invention includes a method of forming a passageway in the wall of a hollow body organ by placing an apparatus into the working lumen of an endoscope and coupling the device to the proximal end of the endoscope. The needle is advanced by moving the actuator which is coupled to the proximal end of the needle. Once in position across the tissue wall, the needle can be fixed to the endoscope by using a locking member. The catheter device can be advanced over the needle by moving the actuator which is coupled to the proximal end of the apparatus. The catheter device can advance over the needle to cross the tissue wall. The catheter device may also contain a balloon that is useful for forming a larger passageway.
BRIEF DESCRIPTION OF THE DRAWINGS
The accompanying drawings are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification. The drawings illustrate embodiments of the invention and, together with the description, serve to explain the principles of the invention. In the drawings,
FIG. 1 is a system view of one embodiment of the apparatus;
FIG. 2 is an exploded assembly view of the apparatus;
FIG. 3 is section view of the proximal end of the needle actuator showing the needle and stylet;
FIG. 4 is a view of the catheter device actuator;
FIG. 5 is a section view of the catheter device actuator;
FIG. 6 is a section view of the assembled catheter device and needle actuators;
FIG. 7 is a view of the handle without the catheter device or needle actuators;
FIG. 8 is a cross sectional view of the handle body taken through the locking groove with the catheter device actuator removed;
FIG. 9 is a cross sectional view of the handle body taken through the locking ramp with the catheter device actuator removed;
FIG. 10 is a cutaway side view of the handle body showing the locking ramp with the needle and catheter device actuators removed;
FIG. 11 is a system view of another embodiment of the apparatus;
FIG. 12 is an exploded assembly view of the apparatus of FIG. 11;
FIG. 13 is view of the needle actuator of FIG. 1;
FIG. 14 is section view of the catheter actuator of FIG. 11;
FIG. 15 is a section view of the assembled catheter device and needle actuators;
FIG. 16A is a cross sectional view of the catheter actuator taken through the holder and inflation port (A-A) with the needle actuator removed;
FIG. 16B is a cross sectional view of the catheter actuator taken through the holder and inflation port (A-A) including the needle actuator and stylet;
FIG. 16C is a cross sectional view of an alternate embodiment of the catheter actuator taken through the inflation port (A-A) with the needle actuator removed;
FIG. 17 is a view of the distal portion of the apparatus loaded into the working channel of an endoscope and adjacent to a tissue wall;
FIG. 18 is a view similar to FIG. 11 showing the needle across the tissue;
FIG. 19 is a view similar to FIG. 12 showing the catheter device across the tissue with the dilation balloon deflated;
FIG. 20 is a view similar to FIG. 13 showing the needle removed and a guidewire positioned across the tissue;
FIG. 21 is a view similar to FIG. 14 showing the catheter device with access to a duct and the guidewire positioned in the duct.
DETAILED DESCRIPTION OF THE INVENTION
It is to be understood that the present invention is not limited to the particular embodiments, materials, and examples described herein, as these may vary. It is also to be understood that the terminology used herein is used for the purpose of describing particular embodiments only, and is not intended to limit the scope of the present invention. It must be noted that as used herein and in the appended claims, the singular forms “a,” “an,” and “the” include the plural reference unless the context clearly dictates otherwise. Unless defined otherwise, all technical terms used herein have the same meanings as commonly understood by one of ordinary skill in the art to which this invention belongs. Specific methods, devices, and materials are described, although any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention
Reference will now be made in detail to the present preferred embodiments of the invention, examples of which are illustrated in the accompanying drawings. Wherever possible the same reference numbers are used in the drawings and the description to refer to the same or like parts, and similar reference numerals are used to refer to similar elements.
The apparatus and method described herein may offer improvements over the techniques currently utilized to perform endoscopy or endosonography guided transluminal creation of therapeutic passageways. The apparatus performs the same result as the current medical practice described but utilizes fewer parts, requires fewer instrument exchanges and provides a more stable and solid platform for performing punctures and therapeutic interventions such as tissue dilation.
As shown in FIG. 1, the apparatus 10 utilizes a handle 15, a catheter device actuator 20 and a needle actuator 22 along with a catheter device 24 and a 22 or 23 gauge hollow sharpened needle 26. Inside the needle is a stylet 28 which fills the inner lumen of the needle in a similar manner to other over-the-wire puncture needles. As will be described, the continuous stainless steel needle is stiffer than a guidewire and provides excellent support for the coaxial advancement of catheter devices over the needle 26.
The handle 15 is designed to be held by a physician to support the apparatus 10 in one hand while the catheter device actuator 20 or the needle actuator 22 or both are manipulated. In each case described in the body of this application, it is assumed that the catheter device actuator 20 may function independently from the needle actuator 22. Although the movement of the needle actuator 22 may be described, it is anticipated that the catheter device 24 may also be simultaneously operated or sequentially operated according to the medical procedure being performed. Conversely, the needle actuator 22 and the catheter device actuator 20 may be operated together as a single unit if required. No inference as to order, sequence or dependence of the catheter device or needle movement on the other is intended.
The handle 15 is particularly useful in integrating the control of the movement of the coaxial system of catheter device 24 and needle 26 into a single location. The actuators for both the catheter device 24 and needle 26 make up a part of the handle. The operator can move the catheter device 24 and needle 26 from these actuators which can make a previously cumbersome procedure easier, less confusing and faster.
As shown in FIG. 2, the handle 15 has a body 30 that is a hollow cylindrical tube that is open at the proximal end 31. The distal end 33 is essentially closed except for a single opening that is sized for the catheter device to pass through. The body 30 functions as a housing for the catheter device and needle actuators and can be constructed from plastic or metal. The body 30 is threaded at the proximal end 31 with threads 34 designed to mate with a cap 32. The cap 32 is designed to screw onto the body 30 and partially close the proximal end 31 of the body 30. The body has one or more slits 36 running parallel to the body axis and perpendicular to the threads 34. These slits 36 intersect the threads 34 and are designed to function as a compression joint as the cap 32 is threaded onto the body. As the cap 32 is threaded onto the body, the cap 32 reduces the effective inside diameter of the body at the proximal end 31. This diameter reduction has the effect of clamping down onto the catheter device actuator 20 that is positioned inside the body and acting as a locking member.
The endoscope 100 shown in FIG. 11 is an important part of the function of the apparatus 10. The apparatus 10 can function without an endoscope but the endoscope can make the performance and accordingly the success of the procedure greater. The endoscope body provides support to the catheter device as the distal portion of the catheter device is passed out of the endoscope tip. In order to push a needle across a tissue wall, often considerable force is required. The inner walls of the endoscope 100 support the catheter device 24 so that a thrust of the needle 26 is translated into a forward thrust of the needle tip 58 across a tissue wall. This is best accomplished if the catheter device 24 and the endoscope 100 are coupled. In this situation all forward movement of the catheter device 24 is expressed as a forward movement of the catheter device distal end and not a corresponding backward movement of the endoscope 100. One of the functions of the handle 15 is to join with the endoscope 100 so that any movement of the catheter device 24 or needle 26 does not cause a reverse movement of the endoscope 100 at the same time. At the distal end of the handle 33 is a connector 38 that mates with a corresponding connector on the endoscope body. The connector 38 is commonly known as a luer connector and mates to a corresponding luer connector found on the proximal end of most endoscopes.
As shown in the exploded assembly view of FIG. 2, the needle actuator 22 is sized to be placed into the inner diameter of the catheter device actuator 20. The catheter device actuator 20 is sized to be placed into the inner diameter of the body 30. The catheter device and needle actuators and the body 30 function together as a combined mechanism. As will be shown this mechanism allows for the independent movement of the catheter device 24 and the needle 26 relative to each other and the endoscope 100.
Turning to FIG. 3, the needle actuator 22 is shown in a section view. The needle actuator is a hollow cylindrical tube 50 with a proximal 52 and distal 54 end. The tube 50 is joined with a hollow needle 26 at the distal end 54 and has a small opening at the proximal end 52 to receive a stylet 56. The needle 26 has a sharpened end 58 that is suitable for puncturing tissue and may have an inner diameter sized to receive a stylet 56. Although a stylet 56 is shown in FIG. 3, the inclusion of a stylet 56 is not required. The stylet shown has an end plug 59 at the proximal end and a generally rounded tip 60 at the distal end. The tube 50 also has a locking tab 62 located toward the distal end 54 of its outside diameter. This locking tab 62 is used to fix the movement of the needle actuator 22 relative the endoscope 100. The tab 62 is designed to mate with a locking groove 45 located on the inner diameter of the handle body 30.
The catheter device actuator 20 is shown in greater detail in FIGS. 4-6. The catheter device actuator 20 controls the movement of the catheter device 24 and can move the catheter device 24 along the central axis of the endoscope. The catheter device actuator 20 has a housing 70 as shown in FIG. 4. The housing 70 is a hollow cylindrical tube that has a distal end and a proximal end. The distal end tapers slightly to join with the sheath 24. The body has a longitudinal slot 72 that is sized to accept the locking tab 62 of the needle body tube 50. The slot 72 is continuous from the proximal end of the housing 70 to approximately three quarters of the distance to the distal end of the housing 70. The proximal end of the body has threads 73 to accept the threads of the end cap 75. The end cap 75 prevents the needle actuator which is positioned inside the hollow interior of the housing 70 from coming out of the housing 70. However, the end cap 75 may be removed so that the needle actuator can be withdrawn from the tissue dilator if desired. The cap has a round hole at its center that allows the proximal portion 52 of the needle actuator 22 and the stylet 28 to extend outside the housing 70.
The catheter device 24 has two inner lumens that extend from the distal end to the proximal end. This catheter device 24 may be constructed from various materials such as plastic polymers, spring coils, silicone or Teflon tubing. The main lumen 77 is the larger and is designed to accept the needle body 26 and is also large enough to accommodate one 0.035″ or up to two 0.021″ guidewires when the needle is removed. The smaller lumen 76 is for inflating and deflating a dilation balloon attached to the distal end of the catheter device. The end of the dilation balloon 25 can be located immediately adjacent to the catheter device end 21. More preferably the distal end of the balloon can be located between the distal end of the catheter device 24 and up to 4 cm from the distal end of the catheter device. The balloon 25 has a preferred inflated diameter of between 5 and 10 mm and an effective balloon length of 3-6 cm. However various balloon lengths and diameters could be used. The catheter device may also be constructed without a dilation balloon in which case the catheter device 24 would have a single lumen and no inflation port.
The catheter device actuator 20 has two lumens corresponding to lumens of the sheath. As shown in FIG. 5, the needle lumen 79 is continuous the entire length of the housing 70. It is connected to the main lumen 77 of the sheath. The inflation lumen 78 extends from the distal end of the housing 70 and is terminated before the proximal end of the housing 70. This lumen communicates with the smaller lumen 76 of the sheath. The housing 70 has an inflation port 83 that is attached to the catheter device actuator and has a luer connector 84 at the outside end suitable for mating with an inflation syringe. The inflation port 83 is used to inflate and deflate the balloon 25. The proximal portion of the inflation lumen 78 is blocked with a plug 81 to prevent leakage of dilation fluid out the proximal end of the inflation lumen 78.
The needle actuator 22 and the catheter device actuator 20 are assembled together in FIG. 6. In this view, it can be seen how the needle actuator 22 is positioned inside the catheter device actuator 20. Also shown is the locking tab 62 which is positioned in the slot 72 and protrudes through the wall of the housing 70. Also shown is the end cap 75 which retains the needle actuator inside the hollow housing 70.
The handle body is shown in greater detail in FIG. 7. The cylindrical body 30 has an opening 40 in the main body. This opening is located in the central portion of the body and is open to the inside of the body 30. The opening 40 is formed in the body 30 to accept the inflation port 83 of the catheter device actuator. The catheter device actuator 20 slides along the inner diameter of the body 30 and the opening provides clearance for the inflation port 83 so that the catheter device actuator 20 can be advanced, retracted and slightly rotated inside the body 30. The surface of the inside wall of the body has a locking groove 45 that is used to interface with the locking tab 62 of the needle actuator 22. The groove 45 is continuous from the proximal end of the body 30 to approximately three fourths of the distance to the distal portion of the body. The outer diameter “x” of the needle actuator tube 50 at the locking tab 62 is slightly less than the inner diameter “y” of the cylindrical body 30 measured at the groove as shown in the cross sectional view of the handle body and needle actuator in FIG. 8. In this figure the sheath actuator has been removed for clarity. The depth of the groove 45 is such that the locking tab 62 has clearance to move freely but not enough clearance to jump out of the groove 45. The locking tab 62 slides in the groove of the body 30 as the needle actuator 22 is advanced and retracted inside the catheter device activator 20.
The groove is interrupted along its length by a locking ramp 47. The locking ramp 47, shown greater detail in FIGS. 9-10, is located along the groove 45. The depth of the locking ramp 47 varies in a radial direction. At the entrance to the locking ramp 47 at the groove 45, the depth of the locking ramp 47 is the same as the bottom of the groove 45 but the side wall gradually slopes to meet the inside diameter of the handle body 30. As the locking tab 62 is advanced and retracted along the groove 45, if the needle actuator body 22 is slightly rotated, the locking tab moves from the locking groove 45 and will travel onto the locking ramp 47. The locking ramp 47 restricts the free movement of the locking tab 62 along the longitudinal axis of the endoscope 100. If the needle actuator body 22 is slightly rotated, the locking tab 62 will travel along the tapering side wall and impinge upon the tapering side wall so that forward travel will eventually be stopped as the clearance is eliminated. At this point the locking tab 62 will remain essentially fixed with regard to the central axis of the endoscope. In this position tab 62 acts as a locking member. If the needle actuator body 22 is rotated even further, the locking tab 62 will continue to travel along the tapering side wall and will wedge itself along the side wall with a hard stop. In this way it is possible for the operator to lock the lateral movement of the needle actuator 22 relative to the endoscope 100 while still permitting movement of the catheter device actuator 20. The operator also has control as to the degree of resistance felt. A slight rotation increases frictional drag but the needle actuator body 22 can still be moved along the endoscope axis. Further rotation increases drag even further until the needle activator body 22 is fixed.
The assembled apparatus is shown in FIG. 1 shows how the various parts are assembled together. The arrows show the directions that the actuators may travel. The needle actuator 22 can be advanced or retracted along the longitudinal axis of the endoscope according to arrow B as required which transmits the same movement to the needle inside the hollow body organ. The needle actuator preferably can travel less than 10 cm. The needle actuator can more preferably travel between 4 and 8 cm. Similarly the catheter device actuator 20 can be advanced or retracted along the longitudinal axis of the endoscope according to arrow A as required which transmits the same movement to the catheter device 24 inside the hollow body organ or structure. The catheter device actuator 20 preferably can travel less than 10 cm. The catheter device actuator 20 can more preferably travel between 4 and 8 cm. The movement of either actuator can also be locked with respect to the endoscope while permitting movement of the other actuator. The needle actuator 20 is locked by rotating it according to C as required which moves the locking tab 62 along the locking ramp 47. The catheter actuator 22 is locked in position by screwing down the cap 32 located at the proximal end 31 of the handle body 30. This apparatus permits the operator to easily control the location and movement of both the needle 26 and catheter device 24. In this way the needle 26 can be advanced first, its position fixed and then the catheter device 24 can be advanced over the needle 26 without concern that the needle 26 will travel further into the tissue at the same time. This might provide for a safer and easier procedure.
An alternative embodiment of the apparatus 10 is shown in FIG. 11. In this embodiment the apparatus 10 utilizes a handle 115, a catheter actuator 120 and a needle actuator 122 along with a catheter device 24 and a 22 or 23 gauge hollow sharpened needle 26. Similarly to the previous embodiment, a stylet 28 can fill the inner lumen of the needle 26.
The handle 115 is designed to be held by a physician to support the apparatus 10 while the catheter actuator 120 or the needle actuator 122 or both are manipulated. In each case, it is assumed that the catheter device 24 and the needle 26 of this embodiment may function as a single unit or independently from each other. That is the catheter actuator 120 and the needle actuator 122 may be simultaneously or sequentially operated. The handle 115 is particularly useful in integrating the control of the movement of the coaxial system of catheter device 24 and needle 26 into a single location. The actuators for both the catheter device 24 and needle 26 make up a part of the handle 115. The operator can move the catheter device 24 and needle 26 from these actuators.
As shown in FIG. 12, the handle 115 has a body 130 that is a hollow cylindrical tube that is manufactured with the proximal end 131 open. The distal end 133 is essentially closed except for a single opening that is sized for the catheter device to pass through. The body 130 functions as a housing for the catheter device and needle actuators and can be constructed from plastic, metal or other suitable material. The body 130 is threaded at the proximal end 131 with threads 134 designed to mate with a cap 132. The cap 132 is designed to screw onto the body 130 and partially close the proximal end 131 of the body 130. The body has one or more slits 136 running parallel to the body axis and perpendicular to the threads 134. These slits 136 intersect the threads 134 and are designed to function as a compression joint as the cap 132 is threaded onto the body. The cap 132 reduces the effective inside diameter of the body at the proximal end 131 to act as a locking member to clamp down onto the needle actuator 122.
The handle 115 couples with the endoscope 100 so that any movement of the catheter device 24 or needle 26 does not cause a reverse movement of the endoscope 100 at the same time. A connector 138 at the distal end of the handle 133 mates with a corresponding connector on the endoscope body. The connector 138 is preferably a luer connector but any connector that can couple the handle and endoscope together is acceptable. The needle 26 is sized to slide inside the needle actuator 122 and inside the inner diameter of the catheter device 24. The proximal end of the needle 26 has a hub 138 that is attached to the needle and the hub 138 is designed to couple with a corresponding connector 139 on the proximal end of the needle actuator 122. This hub 138 facilitates the attachment of the needle to the needle actuator 122 for movement of the needle by the actuator. The hub 138 can be disconnected from the connector 139 and the needle actuator 122 to remove the needle 26 from the needle actuator 122 and the body 130. The needle actuator 122 is sized to slide over the outside of the catheter actuator 120 and then inside the inner diameter of the body 130. The catheter and needle actuators and the body 130 function together as a combined mechanism.
The needle actuator 122 is shown in greater detail in FIG. 13. The needle actuator 122 is a hollow cylindrical tube 150. The distal end is open and the proximal end terminates at the connector 139. The inside diameter of the needle actuator 122 is sized to fit along the outside diameter of the catheter actuator 120. Generally the dimensions of the two diameters are close to one another so that the catheter actuator 120 can travel inside the tube 150 freely but the travel should be smooth and without unusual wobble. The tube 150 has one or more slits 151 that run longitudinally along the major length of the tube 150. The slits are continuous from the outside diameter of the tube 150 through the wall of the tube 150 to the inside diameter. If more than one slit is utilized, the slits 151 should be symmetrically arranged around the circumference of the tube 150.
The catheter actuator 120 is shown in greater detail in FIGS. 14-16. The catheter actuator 120 controls the movement of the catheter device 24 and can move the catheter device 24 along the central axis of the endoscope 100. The catheter device actuator 120 has a housing 160, a holder 162 and an inflation port 164 on the opposite side of the holder 162 as shown in FIG. 14. Similar to the previous embodiment, the catheter device 24 that is coupled to the catheter actuator 120 has two inner lumens that extend from the distal end to the proximal end. The main lumen 77 is the larger and is designed to accept the needle body 26 and is also large enough to accommodate one 0.035″ or up to two 0.021″ guidewires when the needle is removed. The smaller lumen 76 can be used for inflating and deflating a dilation balloon 25 attached to the distal end of the catheter device 24. The catheter device 24 may also be constructed without a dilation balloon in which case the catheter device 24 would have a single lumen and no inflation port.
The inflation lumen 168 is in fluid communication with the smaller lumen 76 of the catheter device 24 and the inflation port 164 of the catheter actuator 120. The inflation port 164 has a luer connector 166 at the outside end suitable for attaching to an inflation syringe. The inflation port 164 is used to inflate and deflate the balloon 25. The proximal portion of the lumen 168 is blocked with a plug 170 to prevent leakage of dilation fluid out the proximal end of the inflation lumen 168. The needle lumen 169 connected to the larger lumen 77 of the catheter device 24 and is open at both ends to receive the needle 26. The holder 162 is coupled to the housing 160 and is used by the operator to advance and retract the catheter actuator 120 along the handle 115. The holder 162 is long enough to extend through the needle actuator body 150 and the handle 115. Although a holder 162 and an inflation port 164 are shown, it is possible to combine the functions of these into one device. In this alternate embodiment, the inflation port 164 would serve as fluid injection site and as a holder so that the operator could use it to manipulate the catheter actuator. This embodiment would eliminate the holder 162 and would require only one slit 151 in the tube 150. This embodiment may be simpler to operate and less expensive. The proximal end 171 of the housing may be lengthened as necessary to insure that some part of the housing is always secure inside the body 115 when the catheter actuator is advanced. The housing is sized to fit snugly inside the needle actuator body 122.
The catheter actuator 120 and the needle actuator 122 are assembled together in FIG. 15. In this view, it can be seen how the needle actuator 122 is positioned outside the catheter actuator 120 but the needle 26 is positioned inside the catheter actuator 120. The holder 162 and the inflation port 164 are shown extending through the slits 151 of the needle actuator 122. FIG. 16A shows a cross section of the catheter actuator 120 taken along section A-A with the needle actuator 122 removed. FIG. 16B shows a cross section of the same catheter actuator 120 taken along section A-A with the needle actuator 122 in place. The slits 151 are shown with the holder 162 and inflation port 164 extending through these slits. The needle 26 and stylet 28 are shown in the center of lumen 169. FIG. 16C shows a cross section of the same catheter actuator 120 taken along section A-A with the needle actuator 122 and the holder 162 removed. In this embodiment the inflation port 164 functions as an inflation fluid introduction site and as a holder. In this embodiment there is only one slit 151 in the needle actuator body 150.
The cylindrical body 115 has two openings in the main body as shown in FIGS. 11 and 12. These openings are located in the central portion of the body and are typically spaced 180° apart. The openings are formed in the body 115 to accept the holder 162 and inflation port 164. The catheter actuator 120 slides along the inner diameter of the body 115 and the openings provide clearance for the holder 162 and inflation port 164 so that the catheter device actuator 20 can be advanced, retracted and even slightly rotated inside the body 115. Along one edge of both openings, again positioned 180° apart, are a series of locking members 182 that are used to interface with the holder 162 and the inflation port 164. As the catheter actuator is advanced, the holder 162 and inflation port 164 move in a distal direction along their respective openings in the body 115. The holder 162 and inflation port 164 can be radially rotated slightly so that the holder and inflation port move into one of these locking members 182 that are sized to accept the holder 162 and the inflation port 164. Once the holder 162 and inflation port 164 are positioned in the locking member 182, their distal movement along the body 115 is prevented. In this way the operator can advance the catheter device 24 until the tip is positioned correctly in the body and then lock the position of the catheter device 24 relative to the endoscope 100.
The assembled apparatus is shown in FIG. 11 and this figure illustrates how the various parts are assembled together. The arrows show the directions that the actuators travel. The needle 26 and stylet 28 can be moved in the directions D as shown. Once the needle 26 is coupled to the needle actuator 122 using the hub 138 and connector 139, the needle 26 and the needle actuator 122 can be moved like a single unit along the inside walls of the body 115 in the directions E. This is accomplished by grasping the connector 139 or the outside of the actuator body and moving it distally while holding the handle 115. Likewise the catheter actuator 120 can be advanced along the inside walls of the needle actuator 122 by using the holder 162 in the directions F as shown. A slight rotational movement, not shown, applied to the holder 162 or the inflation port 164 causes these to move into any one of a number of locking slots 182 located along the edge of the slots. The needle actuator 122 preferably can travel less than 10 cm. The needle actuator 122 can more preferably travel between 4 and 8 cm. The catheter device actuator 120 preferably can travel less than 10 cm. The catheter device actuator 120 can more preferably travel between 4 and 8 cm. The movement of either actuator can also be locked with respect to the endoscope. The movement of the needle actuator 122 can be fixed to the endoscope by tightening the cap 32. This causes the inside diameter of the body 115 to be reduced which impinges on the hollow cylindrical tube 150 of the needle actuator 122. The movement of the catheter actuator 120 can be fixed to the endoscope by rotating the holder 162 into one of the locking slots previously described.
As shown in FIGS. 17-21, the creation of a conduit between a bowel lumen 104 and a targeted luminal structure 102 can be performed using this system. In this procedure the stylet filled needle 26 and catheter device 24 are part of the apparatus that is introduced into the working lumen of an endoscope 100. Referring to the first embodiment, the handle 15 is secured to the outer part of the endoscope working channel using the connector 38. Once the needle 26 is positioned at the puncture site, the needle is advanced up to 8 cm and passed through the wall of the bowel and into the targeted luminal structure as shown in FIG. 20, Once inside the targeted lumen, the stylet 28 can be removed and aspiration applied or contrast medium injected under fluoroscopy to confirm entry into the target lumen. The target location shown in FIGS. 17-19 is a pseudocyst cavity 102 on the other side of the stomach wall 104 but the method may include many other target sites within the human body. The needle 26 is then locked in position by rotating the needle actuator 22 until the locking tab 62 moves into a locking ramp 47 and the needle actuator 22 is fixed. The catheter device 24 is next advanced along the stiff needle and through the tissue wall. The position of the catheter device 24 relative to the targeted lumen can be determined by visualizing the radiopaque marker(s) 96 and 97 using fluoroscopy or by injecting radiopaque dye into the proximal end of the needle with the stylet removed. In the embodiment shown, the radiopaque markers 96 and 98 are located on each end of the dilating balloon. Once at the intended position in the tissue, the catheter device 24 can be locked in position by screwing down the cap 32 of the handle body 30. If the catheter device has a dilation balloon 25 attached to its distal end, the balloon may be inflated using the inflation port 83 with either liquid or gas inflation fluid. The inflated balloon can create a passageway between the bowel and the target organ. The inflated balloon 25 also serves to anchor the sheath 24 in position so that the needle 26 can be exchanged for a guidewire. The needle 26 can be withdrawn so that one 0.035″ or two 0.021″ guidewires can be introduced through the catheter device 24 and into the target lumen. The balloon 25 is deflated and the catheter device 24 can be removed over the guidewire(s) leaving behind an enlarged conduit with at least one guidewire across.
In another method, the device can function as an anchoring catheter to facilitate the placement of a guidewire into a lumen. By way of example this procedure can be used to place a guidewire into a body duct 99 as shown in FIG. 21. The duct is preferably a bile or pancreatic duct. The needle 26 is advanced under endoscopic ultrasound guidance from the duodenum or stomach through the bowel wall and into the bile or pancreatic duct using the sharpened needle tip. The catheter device 24 is then advanced over the needle 26 and into the duct 99. Once in the duct 99, the dilating balloon 25 can be optionally inflated. This may also serve as a means to provide additional anchorage to the system in the duct 99 and prevent pull-out as the needle 26 is retracted. Once the needle 26 is removed, a 0.035″ guidewire can be safely placed in the duct 99 through the catheter device and once the balloon 25 is deflated the catheter device 24 can be withdrawn.
In yet another method, a pre-curved or steerable-tipped catheter can be positioned over the stylet filled needle instead of the balloon device. The curved catheter tip is useful to steer the catheter tip in different directions. By way of example this procedure can be used to place a guidewire into the bile or pancreatic ducts from an anterograde position. The needle 26 is advanced under endoscopic ultrasound guidance from the duodenum or stomach through the bowel wall and into the bile or pancreatic duct using the sharpened needle tip. A catheter is then advanced over the needle and into the duct. The needle is then exchanged for a 0.035″ guidewire.

Claims (10)

1. An apparatus which is configured to be inserted into a hollow body organ through a working channel of an endoscope having a central axis, the apparatus comprising: a handle member which houses a catheter device actuator and a needle actuator,
the handle member having a connecting member configured to detachably affix the handle member to the proximal end of the endoscope to prevent relative movement therebetween,
the catheter device actuator coupled to a proximal end of an elongated catheter device, the catheter device having a distal end, an inflation lumen, and a through lumen,
the needle actuator having a locking mechanism configured to fix the location of the needle actuator relative to the handle member and the endoscope,
a dilation balloon located near the distal end of the catheter device and in fluid communication with the inflation lumen to allow inflation of the balloon,
and an elongated needle positioned in the through lumen of the catheter device, the needle having a proximal end and a distal end, with the needle actuator coupled to the proximal end of the needle,
wherein the needle actuator is configured to move relative to the handle member and the endoscope to slidably move the needle in the through lumen of the catheter device,
wherein the catheter device actuator is configured to move relative to the handle member, the endoscope and the needle to slidably move the catheter device in the working channel of the endoscope,
wherein the needle actuator locking mechanism may be locked to allow the catheter to be advanced or retracted over the needle while the needle and the endoscope remain stationary,
and wherein the needle may be advanced and retracted independently from the catheter.
2. The apparatus of claim 1, wherein the catheter device actuator is capable of translating the position of the catheter device along the central axis of the endoscope.
3. The apparatus of claim 2, wherein the catheter device actuator moves the catheter device between 2 cm and 10 cm relative to the endoscope.
4. The apparatus of claim 2, wherein the catheter device actuator can move the catheter device independently of the needle along the central axis of the endoscope.
5. The apparatus of claim 4, wherein the catheter device actuator has a locking member to fix the position of the catheter device relative to the endoscope.
6. The apparatus of claim 1, wherein the needle actuator is capable of translating the position of the needle along the central axis of the endoscope.
7. The apparatus of claim 6, wherein the needle actuator moves the needle between 2 cm and 10 cm relative to the endoscope.
8. The apparatus of claim 6, wherein the needle actuator can move the needle independently of the catheter device along the central axis of the endoscope.
9. The apparatus of claim 1, wherein the catheter device has at least one radiopaque marker band positioned near the balloon; such marker band visible when viewed with a fluoroscope or x-ray.
10. The apparatus of claim 1, wherein the needle is hollow and a removable elongated stylet is positioned inside a through lumen of the needle.
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Cited By (33)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100268029A1 (en) * 2009-04-21 2010-10-21 Xlumena, Inc. Methods and apparatus for advancing a device from one body lumen to another
US8617196B2 (en) 2004-12-08 2013-12-31 Xlumena, Inc. Method and apparatus for performing needle guided interventions
US20140276635A1 (en) * 2013-03-15 2014-09-18 Coloplast A/S Access sheath
US9381041B2 (en) 2009-04-21 2016-07-05 Xlumena, Inc. Methods and devices for access across adjacent tissue layers
US9522254B2 (en) 2013-01-30 2016-12-20 Vascular Pathways, Inc. Systems and methods for venipuncture and catheter placement
US9616201B2 (en) 2011-01-31 2017-04-11 Vascular Pathways, Inc. Intravenous catheter and insertion device with reduced blood spatter
US9675784B2 (en) 2007-04-18 2017-06-13 Vascular Pathways, Inc. Intravenous catheter insertion and blood sample devices and method of use
US9861792B2 (en) 2011-02-25 2018-01-09 C. R. Bard, Inc. Medical component insertion device including a retractable needle
US9872971B2 (en) 2010-05-14 2018-01-23 C. R. Bard, Inc. Guidewire extension system for a catheter placement device
US9950139B2 (en) 2010-05-14 2018-04-24 C. R. Bard, Inc. Catheter placement device including guidewire and catheter control elements
US10076330B2 (en) 2008-05-12 2018-09-18 Xlumena, Inc. Tissue anchor for securing tissue layers
US10220191B2 (en) 2005-07-06 2019-03-05 Vascular Pathways, Inc. Intravenous catheter insertion device and method of use
US10232146B2 (en) 2014-09-05 2019-03-19 C. R. Bard, Inc. Catheter insertion device including retractable needle
US10384039B2 (en) 2010-05-14 2019-08-20 C. R. Bard, Inc. Catheter insertion device including top-mounted advancement components
US10493262B2 (en) 2016-09-12 2019-12-03 C. R. Bard, Inc. Blood control for a catheter insertion device
US10561407B2 (en) 2017-05-05 2020-02-18 Hoya Corporation Apparatuses and methods for endoscopic tool joints
US20200305685A1 (en) * 2019-03-27 2020-10-01 SPIRATION, INC., d/b/a OLYMPUS RESPIRATORY AMERICA User interface with dual-function control surface for positioning multiple components within a body
USD903100S1 (en) 2015-05-01 2020-11-24 C. R. Bard, Inc. Catheter placement device
USD903101S1 (en) 2011-05-13 2020-11-24 C. R. Bard, Inc. Catheter
US20210000333A1 (en) * 2018-03-19 2021-01-07 Olympus Corporation Insertion assist device for endoscope and endoscope system
US10945735B2 (en) 2004-04-12 2021-03-16 Boston Scientific Scimed, Inc. Luminal structure anchoring devices and methods
US10952732B2 (en) 2013-02-21 2021-03-23 Boston Scientific Scimed Inc. Devices and methods for forming an anastomosis
US11000678B2 (en) 2010-05-14 2021-05-11 C. R. Bard, Inc. Catheter placement device and method
USD921884S1 (en) 2018-07-27 2021-06-08 Bard Access Systems, Inc. Catheter insertion device
US11040176B2 (en) 2015-05-15 2021-06-22 C. R. Bard, Inc. Catheter placement device including an extensible needle safety component
US20220015787A1 (en) * 2020-07-16 2022-01-20 Endogear Llc Grasping Device For Independent Tissue Manipulation During Gastrointestinal Endoscopic Procedures And Methods Of Use
CN114302756A (en) * 2019-09-30 2022-04-08 奥林巴斯株式会社 Device for performing interventional endoscopic ultrasound surgery
US11317905B2 (en) * 2011-11-07 2022-05-03 C.R. Bard, Inc. Instruments for delivering transfascial sutures and methods of transfascial suturing
US11389626B2 (en) 2018-03-07 2022-07-19 Bard Access Systems, Inc. Guidewire advancement and blood flashback systems for a medical device insertion system
US11400260B2 (en) 2017-03-01 2022-08-02 C. R. Bard, Inc. Catheter insertion device
US11559665B2 (en) 2019-08-19 2023-01-24 Becton, Dickinson And Company Midline catheter placement device
US11925779B2 (en) 2010-05-14 2024-03-12 C. R. Bard, Inc. Catheter insertion device including top-mounted advancement components
US11931534B2 (en) 2021-09-09 2024-03-19 C. R. Bard, Inc. Medical component insertion device including a retractable needle

Families Citing this family (70)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050228413A1 (en) * 2004-04-12 2005-10-13 Binmoeller Kenneth F Automated transluminal tissue targeting and anchoring devices and methods
US8784437B2 (en) * 2005-06-09 2014-07-22 Xlumena, Inc. Methods and devices for endosonography-guided fundoplexy
US8777967B2 (en) * 2005-06-09 2014-07-15 Xlumena, Inc. Methods and devices for anchoring to tissue
US8784336B2 (en) 2005-08-24 2014-07-22 C. R. Bard, Inc. Stylet apparatuses and methods of manufacture
US7794407B2 (en) 2006-10-23 2010-09-14 Bard Access Systems, Inc. Method of locating the tip of a central venous catheter
US8388546B2 (en) 2006-10-23 2013-03-05 Bard Access Systems, Inc. Method of locating the tip of a central venous catheter
US9405823B2 (en) * 2007-07-23 2016-08-02 Nuance Communications, Inc. Spoken document retrieval using multiple speech transcription indices
US10751509B2 (en) 2007-11-26 2020-08-25 C. R. Bard, Inc. Iconic representations for guidance of an indwelling medical device
US8781555B2 (en) 2007-11-26 2014-07-15 C. R. Bard, Inc. System for placement of a catheter including a signal-generating stylet
US9521961B2 (en) 2007-11-26 2016-12-20 C. R. Bard, Inc. Systems and methods for guiding a medical instrument
US8849382B2 (en) 2007-11-26 2014-09-30 C. R. Bard, Inc. Apparatus and display methods relating to intravascular placement of a catheter
US10449330B2 (en) 2007-11-26 2019-10-22 C. R. Bard, Inc. Magnetic element-equipped needle assemblies
US9649048B2 (en) 2007-11-26 2017-05-16 C. R. Bard, Inc. Systems and methods for breaching a sterile field for intravascular placement of a catheter
US10524691B2 (en) 2007-11-26 2020-01-07 C. R. Bard, Inc. Needle assembly including an aligned magnetic element
CN103750858B (en) 2007-11-26 2017-04-12 C·R·巴德股份有限公司 Integrated system for intravascular placement of a catheter
US20090143760A1 (en) 2007-11-30 2009-06-04 Jacques Van Dam Methods, Devices, Kits and Systems for Defunctionalizing the Gallbladder
US20090281379A1 (en) * 2008-05-12 2009-11-12 Xlumena, Inc. System and method for transluminal access
WO2010022370A1 (en) 2008-08-22 2010-02-25 C.R. Bard, Inc. Catheter assembly including ecg sensor and magnetic assemblies
US8437833B2 (en) 2008-10-07 2013-05-07 Bard Access Systems, Inc. Percutaneous magnetic gastrostomy
US9173760B2 (en) 2009-04-03 2015-11-03 Metamodix, Inc. Delivery devices and methods for gastrointestinal implants
US9278019B2 (en) 2009-04-03 2016-03-08 Metamodix, Inc Anchors and methods for intestinal bypass sleeves
BRPI1014701B8 (en) 2009-04-03 2021-06-22 Metamodix Inc modular system to treat metabolic disorders such as diabetes and obesity
US9364259B2 (en) * 2009-04-21 2016-06-14 Xlumena, Inc. System and method for delivering expanding trocar through a sheath
US20120130417A1 (en) * 2010-10-25 2012-05-24 Keke Lepulu Apparatus and method for penetrating and enlarging adjacent tissue layers
US20110137394A1 (en) * 2009-05-29 2011-06-09 Xlumena, Inc. Methods and systems for penetrating adjacent tissue layers
US9901347B2 (en) 2009-05-29 2018-02-27 Terus Medical, Inc. Biliary shunts, delivery systems, and methods of using the same
WO2010138277A1 (en) * 2009-05-29 2010-12-02 Xlumena, Inc. Apparatus and method for deploying stent across adjacent tissue layers
US8282667B2 (en) * 2009-06-05 2012-10-09 Entellus Medical, Inc. Sinus dilation catheter
US9125578B2 (en) 2009-06-12 2015-09-08 Bard Access Systems, Inc. Apparatus and method for catheter navigation and tip location
RU2691318C2 (en) 2009-06-12 2019-06-11 Бард Аксесс Системс, Инк. Method for positioning catheter end
US9532724B2 (en) 2009-06-12 2017-01-03 Bard Access Systems, Inc. Apparatus and method for catheter navigation using endovascular energy mapping
AU2010271294B2 (en) 2009-07-10 2015-09-03 Metamodix, Inc. External anchoring configurations for modular gastrointestinal prostheses
US8608687B2 (en) * 2009-07-31 2013-12-17 Medivity, LLC Multi-lumen endoscopic accessory and system
EP2464407A4 (en) 2009-08-10 2014-04-02 Bard Access Systems Inc Devices and methods for endovascular electrography
AU2010300677B2 (en) 2009-09-29 2014-09-04 C.R. Bard, Inc. Stylets for use with apparatus for intravascular placement of a catheter
US9504372B2 (en) 2009-11-13 2016-11-29 Daniel H. Kim Intradural endoscope
WO2011140535A1 (en) 2010-05-07 2011-11-10 Entellus Medical, Inc. Sinus balloon dilation catheters and sinus surgury tools
CA2799360C (en) * 2010-05-14 2018-11-20 C.R. Bard, Inc. Catheter placement device and method
WO2011150358A1 (en) 2010-05-28 2011-12-01 C.R. Bard, Inc. Insertion guidance system for needles and medical components
WO2011150376A1 (en) 2010-05-28 2011-12-01 C.R. Bard, Inc. Apparatus for use with needle insertion guidance system
US11123141B2 (en) * 2010-08-19 2021-09-21 Mayo Foundation For Medical Education And Research Systems and methods for navigating a catheter and delivering a needle
KR101856267B1 (en) 2010-08-20 2018-05-09 씨. 알. 바드, 인크. Reconfirmation of ecg-assisted catheter tip placement
JP2013545517A (en) 2010-10-25 2013-12-26 エックスルミナ, インコーポレイテッド Device and method for penetrating and expanding membranes of adjacent tissue
WO2012058461A1 (en) 2010-10-29 2012-05-03 C.R.Bard, Inc. Bioimpedance-assisted placement of a medical device
WO2013006817A1 (en) 2011-07-06 2013-01-10 C.R. Bard, Inc. Needle length determination and calibration for insertion guidance system
US8662684B2 (en) 2011-11-30 2014-03-04 Izi Medical Products Radiopaque core
US8661573B2 (en) 2012-02-29 2014-03-04 Izi Medical Products Protective cover for medical device having adhesive mechanism
AU2013229837B2 (en) * 2012-03-09 2017-05-11 Clearstream Technologies Limited Medical balloon with a precisely identifiable portion
AU2013331376A1 (en) * 2012-10-18 2015-04-30 C.R. Bard, Inc. Magnetic element-equipped needle assemblies
EP2945566A4 (en) 2013-01-15 2016-10-26 Metamodix Inc System and method for affecting intestinal microbial flora
US10786653B2 (en) 2013-04-05 2020-09-29 Bloodworks LLC Catheter assembly with segmented stabilization system
EP3073910B1 (en) 2014-02-06 2020-07-15 C.R. Bard, Inc. Systems for guidance and placement of an intravascular device
EP3110478A4 (en) * 2014-02-28 2017-10-11 Sentreheart, Inc. Pericardial access devices and methods
BR112016024959B1 (en) * 2014-05-02 2022-12-20 C.R. Bard, Inc INSERTION TOOL FOR INSERTING A CATHETER INTO A PATIENT'S BODY
US9913649B2 (en) 2014-05-28 2018-03-13 Boston Scientific Scimed, Inc. Catheter with radiofrequency cutting tip and heated balloon
US10973584B2 (en) 2015-01-19 2021-04-13 Bard Access Systems, Inc. Device and method for vascular access
US10362965B2 (en) * 2015-04-22 2019-07-30 Acclarent, Inc. System and method to map structures of nasal cavity
WO2016210325A1 (en) 2015-06-26 2016-12-29 C.R. Bard, Inc. Connector interface for ecg-based catheter positioning system
US11000207B2 (en) 2016-01-29 2021-05-11 C. R. Bard, Inc. Multiple coil system for tracking a medical device
US9622897B1 (en) 2016-03-03 2017-04-18 Metamodix, Inc. Pyloric anchors and methods for intestinal bypass sleeves
JP7044374B2 (en) 2016-05-19 2022-03-30 メタモディクス インコーポレイテッド Extraction device
US10792062B2 (en) * 2016-12-16 2020-10-06 Boston Scientific Scimed, Inc. Medical device handles and related methods
CN108392294B (en) * 2017-02-07 2020-05-19 先健科技(深圳)有限公司 Puncture device and anchoring device
KR102560266B1 (en) * 2017-03-17 2023-07-28 백톤 디킨슨 앤드 컴퍼니 Mid-Line Catheter Placement Device
CN106963516B (en) * 2017-03-23 2019-07-26 杭州唯强医疗科技有限公司 Intracavitary orthotopic fenestration sting device
WO2019164838A1 (en) * 2018-02-20 2019-08-29 Boston Scientific Scimed, Inc. Puncture devices, and systems and methods for accessing tissue
WO2020081373A1 (en) 2018-10-16 2020-04-23 Bard Access Systems, Inc. Safety-equipped connection systems and methods thereof for establishing electrical connections
CN114025716A (en) 2019-02-07 2022-02-08 Nxt生物医疗有限责任公司 Rivet diverter and deployment method
CN114929128A (en) * 2020-01-06 2022-08-19 波士顿科学有限公司 Medical device locking assembly and method of use
CN111938788B (en) * 2020-08-25 2021-07-30 哈尔滨医科大学 Interatrial septum puncture assembly

Citations (224)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2127903A (en) 1936-05-05 1938-08-23 Davis & Geck Inc Tube for surgical purposes and method of preparing and using the same
US3039468A (en) 1959-01-07 1962-06-19 Joseph L Price Trocar and method of treating bloat
US3717151A (en) 1971-03-11 1973-02-20 R Collett Flesh penetrating apparatus
US3874388A (en) 1973-02-12 1975-04-01 Ochsner Med Found Alton Shunt defect closure system
US3970090A (en) 1975-02-03 1976-07-20 Physio Medics, Inc. Catheter
US4235238A (en) 1978-05-11 1980-11-25 Olympus Optical Co., Ltd. Apparatus for suturing coeliac tissues
US4608965A (en) 1985-03-27 1986-09-02 Anspach Jr William E Endoscope retainer and tissue retracting device
US4705040A (en) 1985-11-18 1987-11-10 Medi-Tech, Incorporated Percutaneous fixation of hollow organs
US4790813A (en) 1984-12-17 1988-12-13 Intravascular Surgical Instruments, Inc. Method and apparatus for surgically removing remote deposits
US4896678A (en) 1986-12-12 1990-01-30 Olympus Optical Co., Ltd. Endoscopic treating tool
US4950285A (en) 1989-11-27 1990-08-21 Wilk Peter J Suture device
US4973317A (en) 1989-07-14 1990-11-27 Bobrove Arthur M Automatic sheath protection of hypodermic needle
US4990139A (en) 1986-09-10 1991-02-05 Jang G David Tandem independently inflatable/deflatable multiple diameter balloon angioplasty catheter systems
US5024655A (en) * 1989-09-05 1991-06-18 Freeman Andrew B Epidural catheter apparatus and associated method
US5064435A (en) 1990-06-28 1991-11-12 Schneider (Usa) Inc. Self-expanding prosthesis having stable axial length
US5180392A (en) 1988-02-01 1993-01-19 Einar Skeie Anastomotic device
US5183464A (en) 1991-05-17 1993-02-02 Interventional Thermodynamics, Inc. Radially expandable dilator
US5197971A (en) 1990-03-02 1993-03-30 Bonutti Peter M Arthroscopic retractor and method of using the same
US5207229A (en) 1989-12-21 1993-05-04 Advanced Biomedical Devices, Inc. Flexibility steerable guidewire with inflatable balloon
US5209727A (en) 1992-01-29 1993-05-11 Interventional Technologies, Inc. Guide wire with integral angioplasty balloon
US5211651A (en) 1989-08-18 1993-05-18 Evi Corporation Catheter atherotome
US5224945A (en) 1992-01-13 1993-07-06 Interventional Technologies, Inc. Compressible/expandable atherectomy cutter
US5234447A (en) 1990-08-28 1993-08-10 Robert L. Kaster Side-to-end vascular anastomotic staple apparatus
US5258000A (en) 1991-11-25 1993-11-02 Cook Incorporated Tissue aperture repair device
US5261920A (en) 1992-08-21 1993-11-16 Ethicon, Inc. Anvil bushing for circular stapler
US5275611A (en) 1990-11-20 1994-01-04 Innerdyne Medical, Inc. Tension guide and dilator
US5275610A (en) 1991-05-13 1994-01-04 Cook Incorporated Surgical retractors and method of use
US5290249A (en) 1990-10-09 1994-03-01 Vance Products Incorporated Surgical access sheath
US5304198A (en) 1992-11-13 1994-04-19 Target Therapeutics Single-lumen balloon catheter having a directional valve
US5330497A (en) 1989-11-22 1994-07-19 Dexide, Inc. Locking trocar sleeve
US5353785A (en) 1991-07-15 1994-10-11 Wilk Peter J Method for lifting abdominal wall during laparoscopic surgery
US5372588A (en) 1992-11-24 1994-12-13 Farley; Kevin Trocar having blunt tip
US5395349A (en) * 1991-12-13 1995-03-07 Endovascular Technologies, Inc. Dual valve reinforced sheath and method
US5443484A (en) 1992-06-16 1995-08-22 Loma Linda University Medical Center Trocar and method for endoscopic surgery
US5458131A (en) 1992-08-25 1995-10-17 Wilk; Peter J. Method for use in intra-abdominal surgery
US5462561A (en) 1993-08-05 1995-10-31 Voda; Jan K. Suture device
US5470337A (en) 1994-05-17 1995-11-28 Moss; Gerald Surgical fastener
US5495851A (en) 1995-03-23 1996-03-05 Roanoke Gastroenterology, P.C. Use of endoscopic ultrasound and stimulated bilary drainage in the diagnosis of cholecystitis and microlithiasis
US5520700A (en) 1992-11-13 1996-05-28 Technion Research & Development Foundation, Ltd. Stapler device particularly useful in medical suturing
US5536248A (en) 1992-05-11 1996-07-16 Arrow Precision Products, Inc. Method and apparatus for electrosurgically obtaining access to the biliary tree and placing a stent therein
US5536246A (en) 1991-06-21 1996-07-16 The Saunders Group, Inc. Back support system with interchangeable and positionally adjustable orthotic supports
US5620457A (en) 1994-11-23 1997-04-15 Medinol Ltd. Catheter balloon
US5620456A (en) 1995-10-20 1997-04-15 Lasersurge, Inc. Trocar assembly
WO1997027898A1 (en) 1996-02-02 1997-08-07 Transvascular, Inc. Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures
US5662664A (en) 1992-09-04 1997-09-02 Laurus Medical Corporation Endoscopic suture system
US5688247A (en) 1992-06-30 1997-11-18 Hans Haindl Port catheter
US5697944A (en) 1995-11-15 1997-12-16 Interventional Technologies Inc. Universal dilator with expandable incisor
US5709707A (en) 1995-10-30 1998-01-20 Children's Medical Center Corporation Self-centering umbrella-type septal closure device
US5709671A (en) 1995-10-16 1998-01-20 Ethicon Endo-Surgery, Inc. Trocar having an improved tip configuration
US5713870A (en) 1991-11-27 1998-02-03 Yoon; Inbae Retractable safety penetrating instrument with laterally extendable spring strip
US5725552A (en) 1994-07-08 1998-03-10 Aga Medical Corporation Percutaneous catheter directed intravascular occlusion devices
US5797906A (en) 1993-11-24 1998-08-25 Valleylab Inc Retrograde tissue splitter and method
US5817062A (en) 1996-03-12 1998-10-06 Heartport, Inc. Trocar
US5827276A (en) 1995-03-24 1998-10-27 Board Of Regents Of Univ Of Nebraksa Apparatus for volumetric tissue ablation
US5843127A (en) 1994-08-22 1998-12-01 Le Medical Technologies, Inc. Fixation device and method for installing same
US5843116A (en) 1996-05-02 1998-12-01 Cardiovascular Dynamics, Inc. Focalized intraluminal balloons
US5853421A (en) 1995-06-07 1998-12-29 Datascope Investment Corp. Guide wire with releasable barb anchor
US5857999A (en) 1995-05-05 1999-01-12 Imagyn Medical Technologies, Inc. Small diameter introducer for laparoscopic instruments
US5858006A (en) 1992-11-06 1999-01-12 Texas Instruments Incorporated Hypodermic needle with a protrusion
US5882340A (en) 1992-04-15 1999-03-16 Yoon; Inbae Penetrating instrument having an expandable anchoring portion for triggering protrusion of a safety member and/or retraction of a penetrating member
US5893856A (en) 1996-06-12 1999-04-13 Mitek Surgical Products, Inc. Apparatus and method for binding a first layer of material to a second layer of material
US5935107A (en) 1996-10-07 1999-08-10 Applied Medical Resources Corporation Apparatus and method for surgically accessing a body cavity
US5944738A (en) 1998-02-06 1999-08-31 Aga Medical Corporation Percutaneous catheter directed constricting occlusion device
US5951588A (en) 1996-02-29 1999-09-14 Moenning; Stephen P. Apparatus and method for protecting a port site opening in the wall of a body cavity
US5951576A (en) 1998-03-02 1999-09-14 Wakabayashi; Akio End-to-side vascular anastomosing stapling device
US5957363A (en) 1994-06-17 1999-09-28 Elf Atochem S.A. Method of performing vascular anastomosis
US5993447A (en) 1996-08-16 1999-11-30 United States Surgical Apparatus for thermal treatment of tissue
US6007544A (en) 1996-06-14 1999-12-28 Beth Israel Deaconess Medical Center Catheter apparatus having an improved shape-memory alloy cuff and inflatable on-demand balloon for creating a bypass graft in-vivo
US6007522A (en) 1996-09-13 1999-12-28 Boston Scientific Corporation Single operator exchange biliary catheter
US6017352A (en) 1997-09-04 2000-01-25 Kensey Nash Corporation Systems for intravascular procedures and methods of use
US6022359A (en) 1999-01-13 2000-02-08 Frantzen; John J. Stent delivery system featuring a flexible balloon
US6080174A (en) 1993-03-05 2000-06-27 Innerdyne, Inc. Trocar system having expandable port
US6113611A (en) 1998-05-28 2000-09-05 Advanced Vascular Technologies, Llc Surgical fastener and delivery system
US6113609A (en) 1998-05-26 2000-09-05 Scimed Life Systems, Inc. Implantable tissue fastener and system for treating gastroesophageal reflux disease
US6190353B1 (en) 1995-10-13 2001-02-20 Transvascular, Inc. Methods and apparatus for bypassing arterial obstructions and/or performing other transvascular procedures
WO2001021247A1 (en) 1999-09-20 2001-03-29 Appriva Medical, Inc. Method and apparatus for closing a body lumen
US6228039B1 (en) 1997-05-07 2001-05-08 Kenneth F. Binmoeller Biopsy device
US6231587B1 (en) 1995-10-13 2001-05-15 Transvascular, Inc. Devices for connecting anatomical conduits such as vascular structures
US6241758B1 (en) 1999-05-28 2001-06-05 Advanced Cardiovascular Systems, Inc. Self-expanding stent delivery system and method of use
US6251084B1 (en) 1989-08-09 2001-06-26 Medtronic Ave, Inc. Guide catheter and guidewires for effecting rapid catheter exchange
US20010011170A1 (en) 1998-08-20 2001-08-02 Endius Incorporated Method for performing a surgical procedure and a cannula for use in performing the surgical procedure
US6290485B1 (en) 1995-03-02 2001-09-18 Lixiao Wang Mold for forming a balloon catheter having stepped compliance curve
JP2001275947A (en) 2000-03-29 2001-10-09 Olympus Optical Co Ltd Puncture needle control tool for endoscope
US6309415B1 (en) 1993-12-28 2001-10-30 Endovascular Technologies, Inc. Stent
US6334446B1 (en) 1992-11-13 2002-01-01 American Medical Systems, Inc. Medical sling procedures and anchor insertion methods and devices
US6348064B1 (en) 2000-09-01 2002-02-19 Angiolink Corporation Wound site management and wound closure device
US6358264B2 (en) 1996-07-24 2002-03-19 Surgical Design Corporation Surgical instruments with movable member
US6371965B2 (en) 1995-02-24 2002-04-16 Gifford, Iii Hanson S. Devices and methods for performing a vascular anastomosis
US6371964B1 (en) 1999-05-18 2002-04-16 Vascular Innovations, Inc. Trocar for use in deploying an anastomosis device and method of performing anastomosis
US6391036B1 (en) 1998-01-30 2002-05-21 St. Jude Medical Atg Inc. Medical graft connector or plug structures, and methods of making and installing same
US6402770B1 (en) 1998-06-01 2002-06-11 Avatar Design & Development, Inc. Method and apparatus for placing and maintaining a percutaneous tube into a body cavity
US6436119B1 (en) 1999-09-30 2002-08-20 Raymedica, Inc. Adjustable surgical dilator
US6447524B1 (en) 2000-10-19 2002-09-10 Ethicon Endo-Surgery, Inc. Fastener for hernia mesh fixation
US6475222B1 (en) 1998-11-06 2002-11-05 St. Jude Medical Atg, Inc. Minimally invasive revascularization apparatus and methods
US6475185B1 (en) 2000-02-24 2002-11-05 Scimed Life Systems, Inc. Occlusion device
US6485496B1 (en) 1997-10-24 2002-11-26 Wilhelmus Joseph Leonardus Suyker Mechanical anastomosis system for hollow structures
US6488653B1 (en) 1999-08-12 2002-12-03 Wilson-Cook Medical Incorporated Dilation balloon having multiple diameters
US20020183787A1 (en) 2001-06-01 2002-12-05 Velocimed, L.L.C. Closure devices, related delivery methods and tools, and related methods of use
US20020188301A1 (en) 2001-06-11 2002-12-12 Dallara Mark Douglas Tissue anchor insertion system
US20030014063A1 (en) 1996-11-08 2003-01-16 Houser Russell A. Percutaneous bypass graft and securing system
US6508252B1 (en) 1998-11-06 2003-01-21 St. Jude Medical Atg, Inc. Medical grafting methods and apparatus
US20030032975A1 (en) 1999-01-06 2003-02-13 Bonutti Peter M. Arthroscopic retractors
US6520908B1 (en) 1999-09-30 2003-02-18 Olympus Optical Co., Ltd. Electronic endoscope
US20030040803A1 (en) 2001-08-23 2003-02-27 Rioux Robert F. Maintaining an open passageway through a body lumen
US20030045893A1 (en) 2001-09-06 2003-03-06 Integrated Vascular Systems, Inc. Clip apparatus for closing septal defects and methods of use
US20030050665A1 (en) 2001-09-07 2003-03-13 Integrated Vascular Systems, Inc. Needle apparatus for closing septal defects and methods for using such apparatus
WO2003020106A2 (en) 2001-08-28 2003-03-13 Ethicon, Inc. Composite staple for completing an anastomosis
US6535764B2 (en) 2001-05-01 2003-03-18 Intrapace, Inc. Gastric treatment and diagnosis device and method
US20030069533A1 (en) 2001-10-10 2003-04-10 Hiroshi Kakutani Endoscopic transduodenal biliary drainage system
US20030073979A1 (en) 2001-10-15 2003-04-17 Wendy Naimark Medical device for delivering patches
US20030078604A1 (en) 1998-05-21 2003-04-24 Walshe Christopher J. Tissue anchor system
US20030088256A1 (en) 2001-10-03 2003-05-08 Conston Stanley R. Devices and methods for interconnecting vessels
US20030093118A1 (en) 1999-03-01 2003-05-15 Coalescent Surgical, Inc. Tissue connector apparatus with cable release
US6575967B1 (en) 1995-03-24 2003-06-10 The Board Of Regents Of The University Of Nebraska Method and systems for volumetric tissue ablation
US20030109900A1 (en) 2000-09-15 2003-06-12 Jonathan Martinek Knotless tissue anchor
US20030120292A1 (en) 2001-06-20 2003-06-26 Park Medical, Llc Anastomotic device
US6610100B2 (en) 1998-09-10 2003-08-26 Percardia, Inc. Designs for left ventricular conduit
US20030163017A1 (en) 1998-02-19 2003-08-28 Tam Lisa A. Multi layer radiation delivery balloon
US6614595B2 (en) 2001-02-16 2003-09-02 Olympus Optical Co., Ltd. Stereo endoscope
WO2003071962A2 (en) 2002-02-25 2003-09-04 Yeung Jeffrey E Expandable fastener with compressive grips
US6620122B2 (en) 2001-04-26 2003-09-16 Scimed Life Systems, Inc. Gastric pseudocyst drainage and stent delivery system for use therein
US6626919B1 (en) 1997-12-29 2003-09-30 Lee L. Swanstrom Method and apparatus for attaching or locking an implant to an anatomic vessel or hollow organ wall
US6632197B2 (en) 1999-04-16 2003-10-14 Thomas R. Lyon Clear view cannula
US6635068B1 (en) 1998-02-10 2003-10-21 Artemis Medical, Inc. Occlusion, anchoring, tensioning and flow direction apparatus and methods for use
US6638213B2 (en) 2000-10-02 2003-10-28 Olympus Optical Co., Ltd. Endoscope
US6645205B2 (en) 2001-08-15 2003-11-11 Core Medical, Inc. Apparatus and methods for reducing lung volume
US6656206B2 (en) 1999-05-13 2003-12-02 Cardia, Inc. Occlusion device with non-thrombogenic properties
US20030236536A1 (en) 2002-06-20 2003-12-25 Scimed Life Systems, Inc. Endoscopic fundoplication devices and methods for treatment of gastroesophageal reflux disease
US6669708B1 (en) 1999-12-09 2003-12-30 Michael Nissenbaum Devices, systems and methods for creating sutureless on-demand vascular anastomoses and hollow organ communication channels
US6682536B2 (en) 2000-03-22 2004-01-27 Advanced Stent Technologies, Inc. Guidewire introducer sheath
US20040019322A1 (en) 2002-07-23 2004-01-29 Hoffmann Gerard Von Intracranial aspiration catheter
US20040034371A1 (en) 2001-05-18 2004-02-19 Glen Lehman Method of promoting tissue adhesion
US20040049157A1 (en) * 2001-09-13 2004-03-11 Michael Plishka Paracentesis device having multiple detachable components
US20040073108A1 (en) 2002-05-29 2004-04-15 Zahid Saeed Device for directing a wire guide
US6736828B1 (en) 2000-09-29 2004-05-18 Scimed Life Systems, Inc. Method for performing endoluminal fundoplication and apparatus for use in the method
US6746489B2 (en) 1998-08-31 2004-06-08 Wilson-Cook Medical Incorporated Prosthesis having a sleeve valve
US6746472B2 (en) 1999-09-20 2004-06-08 Ev3 Sunnyvale, Inc. Endoluminal anchor
US6749621B2 (en) 2002-02-21 2004-06-15 Integrated Vascular Systems, Inc. Sheath apparatus and methods for delivering a closure device
US6773440B2 (en) 2002-07-02 2004-08-10 Satiety, Inc. Method and device for use in tissue approximation and fixation
US20040236346A1 (en) 2003-04-25 2004-11-25 Cook Incorporated Delivery catheter and method of manufacture
US20040243122A1 (en) 2003-02-13 2004-12-02 Coaptus Medical Corporation Transseptal closure of a patent foramen ovale and other cardiac defects
US20040249985A1 (en) 2001-10-18 2004-12-09 Toshiaki Mori Host network interface device and drive network interface device
US20040260332A1 (en) 1997-11-12 2004-12-23 Genesis Technologies Llc Body passageway occluder and method
US6835189B2 (en) 2002-10-15 2004-12-28 Scimed Life Systems, Inc. Controlled deployment balloon
US20050033327A1 (en) 1999-09-07 2005-02-10 John Gainor Retrievable septal defect closure device
WO2005011463A2 (en) 2003-07-01 2005-02-10 Usgi Medical Inc. Methods and apparatus for gastric reduction
US20050043781A1 (en) 1998-02-13 2005-02-24 Mark Foley Methods and devices providing transmyocardial blood flow to the arterial vascular system of the heart
US20050059990A1 (en) 2003-07-31 2005-03-17 Ayala Juan Carlos System and method for introducing multiple medical devices
US20050075654A1 (en) 2003-10-06 2005-04-07 Brian Kelleher Methods and devices for soft tissue securement
US20050113868A1 (en) 2003-11-20 2005-05-26 Devellian Carol A. Device, with electrospun fabric, for a percutaneous transluminal procedure, and methods thereof
US6902535B2 (en) 2002-08-26 2005-06-07 Kansey Nash Corporation Guide-wire mounted balloon modulation device and methods of use
US6916332B2 (en) 2001-05-23 2005-07-12 Scimed Life Systems, Inc. Endoluminal fundoplication device and related method for installing tissue fastener
US6921387B2 (en) 2001-05-01 2005-07-26 Mayo Foundation For Medical Education And Research Vascular needle
US6921361B2 (en) 2000-07-24 2005-07-26 Olympus Corporation Endoscopic instrument for forming an artificial valve
US20050187567A1 (en) 2004-02-20 2005-08-25 Esophyx, Inc. Tissue fixation devices and assemblies for deploying the same
US6942678B2 (en) 2001-11-06 2005-09-13 Possis Medical, Inc. Gas inflation/evacuation system and sealing system for guidewire assembly having occlusive device
US20050228413A1 (en) 2004-04-12 2005-10-13 Binmoeller Kenneth F Automated transluminal tissue targeting and anchoring devices and methods
WO2005096953A1 (en) 2004-03-31 2005-10-20 Wilson-Cook Medical Inc. Biopsy needle system
US6960233B1 (en) 2002-12-10 2005-11-01 Torax Medical, Inc. Methods and apparatus for improving the function of biological passages
US20050251159A1 (en) 2004-05-07 2005-11-10 Usgi Medical Inc. Methods and apparatus for grasping and cinching tissue anchors
US20050251208A1 (en) 2004-05-07 2005-11-10 Usgi Medical Inc. Linear anchors for anchoring to tissue
US6966917B1 (en) 2000-11-09 2005-11-22 Innovation Interventional Technologies B.V. Deformable connector for mechanically connecting hollow structures
US6974467B1 (en) 2002-11-04 2005-12-13 Gonzales Jr Antonio Method and apparatus for making a precise surgical incision
US20050277981A1 (en) 2004-06-09 2005-12-15 Usgi Medical Inc. Apparatus and methods for optimizing anchoring force
US20060062996A1 (en) 2004-09-22 2006-03-23 Yun-Chao Yeh Resin matrix composite with aluminum for lubrication in drilling
US7018401B1 (en) 1999-02-01 2006-03-28 Board Of Regents, The University Of Texas System Woven intravascular devices and methods for making the same and apparatus for delivery of the same
US20060111672A1 (en) 2002-05-28 2006-05-25 Mercator Medsystems, Inc. Methods and apparatus for aspiration and priming of inflatable structures in catheters
US20060116697A1 (en) 2004-11-30 2006-06-01 Esophyx, Inc. Flexible transoral endoscopic gastroesophageal flap valve restoration device and method
US7056325B1 (en) 1997-06-28 2006-06-06 Medtronic Vascular, Inc. Transluminal methods and devices for closing, forming attachments to, and/or forming anastomotic junctions in, luminal anatomical structures
US20060142703A1 (en) 2004-12-07 2006-06-29 Cook Incorporated Catheter aperture with related structures and method
US20060142790A1 (en) 2004-03-23 2006-06-29 Michael Gertner Methods and devices to facilitate connections between body lumens
US7077850B2 (en) 2002-05-01 2006-07-18 Scimed Life Systems, Inc. Tissue fastening devices and related insertion tools and methods
US20060167482A1 (en) 2003-04-04 2006-07-27 Swain Christopher P Device for transfixing and joining tissue
US20060190021A1 (en) 2005-02-18 2006-08-24 Michael Hausman Cutting device for subcutaneous incisions
US20060200177A1 (en) 2003-04-16 2006-09-07 Tyco Healthcare Group Lp Method and apparatus for radical prostatectomy anastomosis including an anchor for engaging a body vessel and deployable sutures
US20060217762A1 (en) 2004-06-09 2006-09-28 Usgi Medical, Inc. Compressible tissue anchor assemblies
US20060217748A1 (en) 2003-09-30 2006-09-28 Ethicon Endo-Surgery, Inc. Method for Hybrid Gastro-Jejunostomy
US20060224183A1 (en) 2003-01-21 2006-10-05 Franz Freudenthal Implantable device
US20060259074A1 (en) 2005-02-22 2006-11-16 Brian Kelleher Methods and devices for anchoring to soft tissue
US20060259051A1 (en) 2005-04-08 2006-11-16 Alveolus, Inc. Duodenum stent and associated method
US20060282087A1 (en) 2005-06-09 2006-12-14 Binmoeller Kenneth F Methods and devices for endosonography-guided fundopexy
US7150723B2 (en) 2001-11-29 2006-12-19 C-I-Medic Co., Ltd. Medical device including guide wire and balloon catheter for curing a coronary artery
US7153314B2 (en) 1999-06-22 2006-12-26 Ndo Surgical Tissue reconfiguration
US7156857B2 (en) 2001-04-04 2007-01-02 Olympus Optical Co., Ltd. Endoscopic instruments
US7169161B2 (en) 2001-11-06 2007-01-30 Possis Medical, Inc. Guidewire having occlusive device and repeatably crimpable proximal end
US20070027534A1 (en) 2005-07-27 2007-02-01 Bjarne Bergheim Methods and systems for cardiac valve delivery
US7182771B1 (en) 2001-12-20 2007-02-27 Russell A. Houser Vascular couplers, techniques, methods, and accessories
US20070066863A1 (en) 2005-08-31 2007-03-22 Medtronic Vascular, Inc. Device for treating mitral valve regurgitation
US7204842B2 (en) 2000-05-10 2007-04-17 Boston Scientific Scimed, Inc. Devices and related methods for securing a tissue fold
US20070112363A1 (en) 2005-11-15 2007-05-17 Endogastric Solutions, Inc. Apparatus including multiple invaginators for restoring a gastroesophageal flap valve and method
US20070123917A1 (en) 2005-11-29 2007-05-31 Ortiz Mark S Anastomotic device promoting tissue necrosis
US20070123840A1 (en) 2005-10-18 2007-05-31 Usgi Medical, Inc. Instrument assisted abdominal access
US20070123934A1 (en) 2005-09-26 2007-05-31 Whisenant Brian K Delivery system for patent foramen ovale closure device
US20070135825A1 (en) 2005-06-09 2007-06-14 Binmoeller Kenneth F Methods and devices for anchoring to tissue
US20070179426A1 (en) 2004-05-11 2007-08-02 Selden Nathan R Interfacial stent and method of maintaining patency of surgical fenestrations
US20070197862A1 (en) 2004-06-18 2007-08-23 Jacques Deviere Endoscopic device
US20070213812A1 (en) 2002-11-15 2007-09-13 Webler William E Apparatuses and methods for delivering/deploying a medical device in a vessel
US7273451B2 (en) 2003-03-04 2007-09-25 Olympus Corporation Endoscopic treatment system and anastomotic method using this system
US7303531B2 (en) 1998-09-03 2007-12-04 Rubicor Medical, Inc. Excisional biopsy devices and methods
US7309341B2 (en) 2003-09-30 2007-12-18 Ethicon Endo-Surgery, Inc. Single lumen anastomosis applier for self-deploying fastener
US20080071301A1 (en) 1999-09-20 2008-03-20 Nuvasive, Inc. Annulotomy closure device and related methods
US7361180B2 (en) 2004-05-07 2008-04-22 Usgi Medical, Inc. Apparatus for manipulating and securing tissue
US7377897B1 (en) 2002-05-02 2008-05-27 Kunkel Sanford S Portal device
US7416554B2 (en) 2002-12-11 2008-08-26 Usgi Medical Inc Apparatus and methods for forming and securing gastrointestinal tissue folds
US7429264B2 (en) 2004-06-15 2008-09-30 Warsaw Orthopedic, Inc. Minimally invasive deployable cutting instrument
US20080243151A1 (en) 2004-04-12 2008-10-02 Binmoeller Kenneth F Luminal Structure Anchoring Devices and Methods
US7534247B2 (en) 2005-05-03 2009-05-19 Ethicon Endo-Surgery, Inc. Sheathless anastomotic ring applier device
US20090177288A1 (en) 2005-10-29 2009-07-09 Pnn Medical S.A. Stent for Use in a Tubular Organ of a Body
US7591828B2 (en) 2005-07-22 2009-09-22 Ethicon Endo-Surgery, Inc. Resposable anastomotic ring applier device
US20090281557A1 (en) 2008-05-12 2009-11-12 Xlumena, Inc. Tissue anchor for securing tissue layers
US20090281379A1 (en) 2008-05-12 2009-11-12 Xlumena, Inc. System and method for transluminal access
US20100130993A1 (en) 2005-07-25 2010-05-27 Adrian Paz Anastomosis device and system
US20100268175A1 (en) 2009-04-21 2010-10-21 Xlumena, Inc. System and method for delivering expanding trocar through a sheath
US20100268029A1 (en) 2009-04-21 2010-10-21 Xlumena, Inc. Methods and apparatus for advancing a device from one body lumen to another
US7845536B2 (en) 2004-10-18 2010-12-07 Tyco Healthcare Group Lp Annular adhesive structure
US20110112622A1 (en) 2009-05-29 2011-05-12 Xlumena, Inc. Apparatus and method for deploying stent across adjacent tissue layers
US7942890B2 (en) 2005-03-15 2011-05-17 Tyco Healthcare Group Lp Anastomosis composite gasket
US20110137394A1 (en) 2009-05-29 2011-06-09 Xlumena, Inc. Methods and systems for penetrating adjacent tissue layers
US7998155B2 (en) 2002-06-20 2011-08-16 Tyco Healthcare Group Lp Method and apparatus for anastomosis including annular joining member
US8034063B2 (en) 2007-07-13 2011-10-11 Xlumena, Inc. Methods and systems for treating hiatal hernias
WO2012033760A1 (en) 2010-09-07 2012-03-15 Boston Scientific Scimed, Inc. Endoscopic ultrasound fine needle aspiration device
US20120109277A1 (en) 2010-10-25 2012-05-03 Keke Lepulu Apparatus and method for penetrating and enlarging adjacent tissue layers
US20120130417A1 (en) 2010-10-25 2012-05-24 Keke Lepulu Apparatus and method for penetrating and enlarging adjacent tissue layers
US8187289B2 (en) 2004-11-05 2012-05-29 Ethicon Endo-Surgery, Inc. Device and method for the therapy of obesity

Family Cites Families (60)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS5835219B2 (en) 1975-02-04 1983-08-01 大日本インキ化学工業株式会社 Seizouhouhou
US4173392A (en) 1977-07-20 1979-11-06 American Hospital Supply Corporation Glass fiber light guide and method of making the same
US4587972A (en) 1984-07-16 1986-05-13 Morantte Jr Bernardo D Device for diagnostic and therapeutic intravascular intervention
US5000185A (en) 1986-02-28 1991-03-19 Cardiovascular Imaging Systems, Inc. Method for intravascular two-dimensional ultrasonography and recanalization
US4920967A (en) 1986-07-18 1990-05-01 Pfizer Hospital Products Group, Inc. Doppler tip wire guide
US4917097A (en) 1987-10-27 1990-04-17 Endosonics Corporation Apparatus and method for imaging small cavities
US4869263A (en) 1988-02-04 1989-09-26 Cardiometrics, Inc. Device and method for measuring volumetric blood flow in a vessel
US5588432A (en) 1988-03-21 1996-12-31 Boston Scientific Corporation Catheters for imaging, sensing electrical potentials, and ablating tissue
US5021059A (en) 1990-05-07 1991-06-04 Kensey Nash Corporation Plug device with pulley for sealing punctures in tissue and methods of use
EP0479730B1 (en) 1990-10-04 1995-04-19 Schneider (Europe) Ag Balloon dilatation catheter
US5221258A (en) 1991-01-22 1993-06-22 Shturman Technologies, Inc. Introduction balloon catheter
EP0533321A3 (en) 1991-07-22 1993-05-12 Dow Corning Wright Corporation Expanding atherectomy device
EP0544485B1 (en) 1991-11-25 1995-03-08 Cook Incorporated Tissue aperture repair device
US5257990A (en) 1992-02-24 1993-11-02 Kensey Nash Corporation Electrosurgical catheter instrument with impacting working head and method of use
US5226421A (en) 1992-03-06 1993-07-13 Cardiometrics, Inc. Doppler elongate flexible member having an inflatable balloon mounted thereon
US5246007A (en) 1992-03-13 1993-09-21 Cardiometrics, Inc. Vascular catheter for measuring flow characteristics and method
WO1994023786A1 (en) 1993-04-13 1994-10-27 Boston Scientific Corporation Prosthesis delivery system
US5897567A (en) 1993-04-29 1999-04-27 Scimed Life Systems, Inc. Expandable intravascular occlusion material removal devices and methods of use
US5417687A (en) 1993-04-30 1995-05-23 Medical Scientific, Inc. Bipolar electrosurgical trocar
US5415664A (en) 1994-03-30 1995-05-16 Corvita Corporation Method and apparatus for introducing a stent or a stent-graft
JP2672464B2 (en) * 1994-05-02 1997-11-05 オリンパス光学工業株式会社 Balloon catheter
JP3614943B2 (en) 1994-09-29 2005-01-26 オリンパス株式会社 Endoscopic puncture needle
US5702418A (en) 1995-09-12 1997-12-30 Boston Scientific Corporation Stent delivery system
US5632762A (en) 1995-11-09 1997-05-27 Hemodynamics, Inc. Ostial stent balloon
SE510577C2 (en) 1996-05-08 1999-06-07 Carag Ag Device for implants
US6379319B1 (en) 1996-10-11 2002-04-30 Transvascular, Inc. Systems and methods for directing and snaring guidewires
ATE520356T1 (en) 1997-09-26 2011-09-15 Cryolife Inc SEAMLESS ANASTOMOTIS DEVICE
US6074416A (en) 1997-10-09 2000-06-13 St. Jude Medical Cardiovascular Group, Inc. Wire connector structures for tubular grafts
US5989231A (en) 1998-01-15 1999-11-23 Scimed Life Systems, Inc. Optical gastrostomy and jejunostomy
JP3581591B2 (en) 1999-02-25 2004-10-27 ペンタックス株式会社 Drainage tube indwelling device for endoscope
US6036698A (en) 1998-10-30 2000-03-14 Vivant Medical, Inc. Expandable ring percutaneous tissue removal device
US6231515B1 (en) 1999-01-13 2001-05-15 Scimed Life Systems, Inc. Safety mechanism and method to prevent rotating imaging guide device from exiting a catheter
AU2851000A (en) 1999-01-15 2000-08-01 Ventrica, Inc. Methods and devices for forming vascular anastomoses
DK200001852A (en) * 1999-12-14 2001-06-15 Asahi Optical Co Ltd Manipulation section for an endoscopic treatment instrument
EP1261294B1 (en) 2000-03-10 2006-11-29 Paracor Medical, Inc. Expandable cardiac harness for treating congestive heart failure
US6468303B1 (en) 2000-03-27 2002-10-22 Aga Medical Corporation Retrievable self expanding shunt
US6214029B1 (en) 2000-04-26 2001-04-10 Microvena Corporation Septal defect occluder
AU2002212026A1 (en) 2000-11-07 2002-05-21 Carag Ag A device for plugging an opening such as in a wall of a hollow or tubular organ
US6475168B1 (en) 2000-11-10 2002-11-05 Scimed Life Systems, Inc. Guide wire having x-ray transparent window for x-ray catheter
EP1460945B1 (en) 2001-09-14 2013-01-09 ArthroCare Corporation Electrosurgical apparatus for tissue treatment & removal
JP4473115B2 (en) 2002-05-17 2010-06-02 タイコ ヘルスケア グループ エルピー Endoscopic organ traction system and method of use thereof
EP1513440A2 (en) 2002-05-30 2005-03-16 The Board of Trustees of The Leland Stanford Junior University Apparatus and method for coronary sinus access
US9149602B2 (en) 2005-04-22 2015-10-06 Advanced Cardiovascular Systems, Inc. Dual needle delivery system
US7166088B2 (en) * 2003-01-27 2007-01-23 Heuser Richard R Catheter introducer system
GB0307715D0 (en) 2003-04-03 2003-05-07 Ethicon Endo Surgery Inc Guide wire structure for insertion into an internal space
CA2482697C (en) 2003-09-30 2012-11-20 Ethicon Endo-Surgery, Inc. Applier for a surgical device
CA2482707C (en) 2003-09-30 2013-07-02 Ethicon Endo-Surgery, Inc. Applier having automated release of surgical device
US20050080444A1 (en) 2003-10-14 2005-04-14 Kraemer Stefan J.M. Transesophageal gastric reduction device, system and method
US7229457B2 (en) 2003-10-31 2007-06-12 Medtronic, Inc. Surgical instrument with adjustable rotary cutting tool and method of cutting
US7803150B2 (en) 2004-04-21 2010-09-28 Acclarent, Inc. Devices, systems and methods useable for treating sinusitis
US8475476B2 (en) 2004-06-01 2013-07-02 Cook Medical Technologies Llc System and method for accessing a body cavity
JP5111112B2 (en) 2004-12-08 2012-12-26 エックスルミナ, インコーポレイテッド Device for performing needle-guided therapy
CN101115437A (en) 2005-01-06 2008-01-30 G.I.视频有限公司 Gastrointestinal tool over guiding element
AU2006211174B2 (en) 2005-01-27 2012-05-31 Cook Medical Technologies Llc Endoscopic cutting device
CN101541227B (en) 2005-02-10 2013-06-05 G.I.视频有限公司 Advancement techniques for gastrointestinal tool with guiding element
JP2006223338A (en) 2005-02-15 2006-08-31 Humed Co Ltd Catheter
US9427142B2 (en) 2005-08-08 2016-08-30 Smart Medical Systems Ltd Balloon guided endoscopy
US7758565B2 (en) 2005-10-18 2010-07-20 Cook Incorporated Identifiable wire guide
US7731693B2 (en) 2005-10-27 2010-06-08 Cook Incorporated Coupling wire guide
US7850712B2 (en) 2005-11-15 2010-12-14 Ethicon Endo-Surgery, Inc. Self-shielding suture anchor

Patent Citations (228)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2127903A (en) 1936-05-05 1938-08-23 Davis & Geck Inc Tube for surgical purposes and method of preparing and using the same
US3039468A (en) 1959-01-07 1962-06-19 Joseph L Price Trocar and method of treating bloat
US3717151A (en) 1971-03-11 1973-02-20 R Collett Flesh penetrating apparatus
US3874388A (en) 1973-02-12 1975-04-01 Ochsner Med Found Alton Shunt defect closure system
US3970090A (en) 1975-02-03 1976-07-20 Physio Medics, Inc. Catheter
US4235238A (en) 1978-05-11 1980-11-25 Olympus Optical Co., Ltd. Apparatus for suturing coeliac tissues
US4790813A (en) 1984-12-17 1988-12-13 Intravascular Surgical Instruments, Inc. Method and apparatus for surgically removing remote deposits
US4608965A (en) 1985-03-27 1986-09-02 Anspach Jr William E Endoscope retainer and tissue retracting device
US4705040A (en) 1985-11-18 1987-11-10 Medi-Tech, Incorporated Percutaneous fixation of hollow organs
US4990139A (en) 1986-09-10 1991-02-05 Jang G David Tandem independently inflatable/deflatable multiple diameter balloon angioplasty catheter systems
US4896678A (en) 1986-12-12 1990-01-30 Olympus Optical Co., Ltd. Endoscopic treating tool
US5180392A (en) 1988-02-01 1993-01-19 Einar Skeie Anastomotic device
US4973317A (en) 1989-07-14 1990-11-27 Bobrove Arthur M Automatic sheath protection of hypodermic needle
US6251084B1 (en) 1989-08-09 2001-06-26 Medtronic Ave, Inc. Guide catheter and guidewires for effecting rapid catheter exchange
US5211651A (en) 1989-08-18 1993-05-18 Evi Corporation Catheter atherotome
US5024655A (en) * 1989-09-05 1991-06-18 Freeman Andrew B Epidural catheter apparatus and associated method
US5330497A (en) 1989-11-22 1994-07-19 Dexide, Inc. Locking trocar sleeve
US4950285A (en) 1989-11-27 1990-08-21 Wilk Peter J Suture device
US5207229A (en) 1989-12-21 1993-05-04 Advanced Biomedical Devices, Inc. Flexibility steerable guidewire with inflatable balloon
US5197971A (en) 1990-03-02 1993-03-30 Bonutti Peter M Arthroscopic retractor and method of using the same
US5064435A (en) 1990-06-28 1991-11-12 Schneider (Usa) Inc. Self-expanding prosthesis having stable axial length
US5234447A (en) 1990-08-28 1993-08-10 Robert L. Kaster Side-to-end vascular anastomotic staple apparatus
US5290249A (en) 1990-10-09 1994-03-01 Vance Products Incorporated Surgical access sheath
US5275611A (en) 1990-11-20 1994-01-04 Innerdyne Medical, Inc. Tension guide and dilator
US5275610A (en) 1991-05-13 1994-01-04 Cook Incorporated Surgical retractors and method of use
US5183464A (en) 1991-05-17 1993-02-02 Interventional Thermodynamics, Inc. Radially expandable dilator
US5536246A (en) 1991-06-21 1996-07-16 The Saunders Group, Inc. Back support system with interchangeable and positionally adjustable orthotic supports
US5353785A (en) 1991-07-15 1994-10-11 Wilk Peter J Method for lifting abdominal wall during laparoscopic surgery
US5258000A (en) 1991-11-25 1993-11-02 Cook Incorporated Tissue aperture repair device
US5713870A (en) 1991-11-27 1998-02-03 Yoon; Inbae Retractable safety penetrating instrument with laterally extendable spring strip
US5395349A (en) * 1991-12-13 1995-03-07 Endovascular Technologies, Inc. Dual valve reinforced sheath and method
US5224945A (en) 1992-01-13 1993-07-06 Interventional Technologies, Inc. Compressible/expandable atherectomy cutter
US5209727A (en) 1992-01-29 1993-05-11 Interventional Technologies, Inc. Guide wire with integral angioplasty balloon
US5882340A (en) 1992-04-15 1999-03-16 Yoon; Inbae Penetrating instrument having an expandable anchoring portion for triggering protrusion of a safety member and/or retraction of a penetrating member
US5536248A (en) 1992-05-11 1996-07-16 Arrow Precision Products, Inc. Method and apparatus for electrosurgically obtaining access to the biliary tree and placing a stent therein
US5443484A (en) 1992-06-16 1995-08-22 Loma Linda University Medical Center Trocar and method for endoscopic surgery
US5688247A (en) 1992-06-30 1997-11-18 Hans Haindl Port catheter
US5261920A (en) 1992-08-21 1993-11-16 Ethicon, Inc. Anvil bushing for circular stapler
US5458131A (en) 1992-08-25 1995-10-17 Wilk; Peter J. Method for use in intra-abdominal surgery
US5662664A (en) 1992-09-04 1997-09-02 Laurus Medical Corporation Endoscopic suture system
US5858006A (en) 1992-11-06 1999-01-12 Texas Instruments Incorporated Hypodermic needle with a protrusion
US5304198A (en) 1992-11-13 1994-04-19 Target Therapeutics Single-lumen balloon catheter having a directional valve
US5520700A (en) 1992-11-13 1996-05-28 Technion Research & Development Foundation, Ltd. Stapler device particularly useful in medical suturing
US6334446B1 (en) 1992-11-13 2002-01-01 American Medical Systems, Inc. Medical sling procedures and anchor insertion methods and devices
US5372588A (en) 1992-11-24 1994-12-13 Farley; Kevin Trocar having blunt tip
US6080174A (en) 1993-03-05 2000-06-27 Innerdyne, Inc. Trocar system having expandable port
US5462561A (en) 1993-08-05 1995-10-31 Voda; Jan K. Suture device
US5797906A (en) 1993-11-24 1998-08-25 Valleylab Inc Retrograde tissue splitter and method
US6309415B1 (en) 1993-12-28 2001-10-30 Endovascular Technologies, Inc. Stent
US5470337A (en) 1994-05-17 1995-11-28 Moss; Gerald Surgical fastener
US5957363A (en) 1994-06-17 1999-09-28 Elf Atochem S.A. Method of performing vascular anastomosis
US5725552A (en) 1994-07-08 1998-03-10 Aga Medical Corporation Percutaneous catheter directed intravascular occlusion devices
US5843127A (en) 1994-08-22 1998-12-01 Le Medical Technologies, Inc. Fixation device and method for installing same
US5620457A (en) 1994-11-23 1997-04-15 Medinol Ltd. Catheter balloon
US6371965B2 (en) 1995-02-24 2002-04-16 Gifford, Iii Hanson S. Devices and methods for performing a vascular anastomosis
US6290485B1 (en) 1995-03-02 2001-09-18 Lixiao Wang Mold for forming a balloon catheter having stepped compliance curve
US5495851A (en) 1995-03-23 1996-03-05 Roanoke Gastroenterology, P.C. Use of endoscopic ultrasound and stimulated bilary drainage in the diagnosis of cholecystitis and microlithiasis
US6454765B1 (en) 1995-03-24 2002-09-24 The Board Of Regents Of The University Of Nebraska Methods for volumetric tissue ablation
US5855576A (en) 1995-03-24 1999-01-05 Board Of Regents Of University Of Nebraska Method for volumetric tissue ablation
US5827276A (en) 1995-03-24 1998-10-27 Board Of Regents Of Univ Of Nebraksa Apparatus for volumetric tissue ablation
US6575967B1 (en) 1995-03-24 2003-06-10 The Board Of Regents Of The University Of Nebraska Method and systems for volumetric tissue ablation
US5857999A (en) 1995-05-05 1999-01-12 Imagyn Medical Technologies, Inc. Small diameter introducer for laparoscopic instruments
US5853421A (en) 1995-06-07 1998-12-29 Datascope Investment Corp. Guide wire with releasable barb anchor
US6231587B1 (en) 1995-10-13 2001-05-15 Transvascular, Inc. Devices for connecting anatomical conduits such as vascular structures
US6190353B1 (en) 1995-10-13 2001-02-20 Transvascular, Inc. Methods and apparatus for bypassing arterial obstructions and/or performing other transvascular procedures
US5709671A (en) 1995-10-16 1998-01-20 Ethicon Endo-Surgery, Inc. Trocar having an improved tip configuration
US5620456A (en) 1995-10-20 1997-04-15 Lasersurge, Inc. Trocar assembly
US5709707A (en) 1995-10-30 1998-01-20 Children's Medical Center Corporation Self-centering umbrella-type septal closure device
US5697944A (en) 1995-11-15 1997-12-16 Interventional Technologies Inc. Universal dilator with expandable incisor
WO1997027898A1 (en) 1996-02-02 1997-08-07 Transvascular, Inc. Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures
US6616675B1 (en) 1996-02-02 2003-09-09 Transvascular, Inc. Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures
US5951588A (en) 1996-02-29 1999-09-14 Moenning; Stephen P. Apparatus and method for protecting a port site opening in the wall of a body cavity
US5817062A (en) 1996-03-12 1998-10-06 Heartport, Inc. Trocar
US5843116A (en) 1996-05-02 1998-12-01 Cardiovascular Dynamics, Inc. Focalized intraluminal balloons
US5893856A (en) 1996-06-12 1999-04-13 Mitek Surgical Products, Inc. Apparatus and method for binding a first layer of material to a second layer of material
US6007544A (en) 1996-06-14 1999-12-28 Beth Israel Deaconess Medical Center Catheter apparatus having an improved shape-memory alloy cuff and inflatable on-demand balloon for creating a bypass graft in-vivo
US6358264B2 (en) 1996-07-24 2002-03-19 Surgical Design Corporation Surgical instruments with movable member
US5993447A (en) 1996-08-16 1999-11-30 United States Surgical Apparatus for thermal treatment of tissue
US6007522A (en) 1996-09-13 1999-12-28 Boston Scientific Corporation Single operator exchange biliary catheter
US5935107A (en) 1996-10-07 1999-08-10 Applied Medical Resources Corporation Apparatus and method for surgically accessing a body cavity
US20030014063A1 (en) 1996-11-08 2003-01-16 Houser Russell A. Percutaneous bypass graft and securing system
US6228039B1 (en) 1997-05-07 2001-05-08 Kenneth F. Binmoeller Biopsy device
US7056325B1 (en) 1997-06-28 2006-06-06 Medtronic Vascular, Inc. Transluminal methods and devices for closing, forming attachments to, and/or forming anastomotic junctions in, luminal anatomical structures
US6017352A (en) 1997-09-04 2000-01-25 Kensey Nash Corporation Systems for intravascular procedures and methods of use
US6485496B1 (en) 1997-10-24 2002-11-26 Wilhelmus Joseph Leonardus Suyker Mechanical anastomosis system for hollow structures
US20040260332A1 (en) 1997-11-12 2004-12-23 Genesis Technologies Llc Body passageway occluder and method
US6626919B1 (en) 1997-12-29 2003-09-30 Lee L. Swanstrom Method and apparatus for attaching or locking an implant to an anatomic vessel or hollow organ wall
US6391036B1 (en) 1998-01-30 2002-05-21 St. Jude Medical Atg Inc. Medical graft connector or plug structures, and methods of making and installing same
US5944738A (en) 1998-02-06 1999-08-31 Aga Medical Corporation Percutaneous catheter directed constricting occlusion device
US6635068B1 (en) 1998-02-10 2003-10-21 Artemis Medical, Inc. Occlusion, anchoring, tensioning and flow direction apparatus and methods for use
US20050043781A1 (en) 1998-02-13 2005-02-24 Mark Foley Methods and devices providing transmyocardial blood flow to the arterial vascular system of the heart
US20030163017A1 (en) 1998-02-19 2003-08-28 Tam Lisa A. Multi layer radiation delivery balloon
US5951576A (en) 1998-03-02 1999-09-14 Wakabayashi; Akio End-to-side vascular anastomosing stapling device
US20030078604A1 (en) 1998-05-21 2003-04-24 Walshe Christopher J. Tissue anchor system
US6113609A (en) 1998-05-26 2000-09-05 Scimed Life Systems, Inc. Implantable tissue fastener and system for treating gastroesophageal reflux disease
US6113611A (en) 1998-05-28 2000-09-05 Advanced Vascular Technologies, Llc Surgical fastener and delivery system
US6402770B1 (en) 1998-06-01 2002-06-11 Avatar Design & Development, Inc. Method and apparatus for placing and maintaining a percutaneous tube into a body cavity
US20010011170A1 (en) 1998-08-20 2001-08-02 Endius Incorporated Method for performing a surgical procedure and a cannula for use in performing the surgical procedure
US6746489B2 (en) 1998-08-31 2004-06-08 Wilson-Cook Medical Incorporated Prosthesis having a sleeve valve
US7303531B2 (en) 1998-09-03 2007-12-04 Rubicor Medical, Inc. Excisional biopsy devices and methods
US6610100B2 (en) 1998-09-10 2003-08-26 Percardia, Inc. Designs for left ventricular conduit
US6475222B1 (en) 1998-11-06 2002-11-05 St. Jude Medical Atg, Inc. Minimally invasive revascularization apparatus and methods
US6508252B1 (en) 1998-11-06 2003-01-21 St. Jude Medical Atg, Inc. Medical grafting methods and apparatus
US20030032975A1 (en) 1999-01-06 2003-02-13 Bonutti Peter M. Arthroscopic retractors
US6022359A (en) 1999-01-13 2000-02-08 Frantzen; John J. Stent delivery system featuring a flexible balloon
US7018401B1 (en) 1999-02-01 2006-03-28 Board Of Regents, The University Of Texas System Woven intravascular devices and methods for making the same and apparatus for delivery of the same
US20030093118A1 (en) 1999-03-01 2003-05-15 Coalescent Surgical, Inc. Tissue connector apparatus with cable release
US6632197B2 (en) 1999-04-16 2003-10-14 Thomas R. Lyon Clear view cannula
US6656206B2 (en) 1999-05-13 2003-12-02 Cardia, Inc. Occlusion device with non-thrombogenic properties
US6371964B1 (en) 1999-05-18 2002-04-16 Vascular Innovations, Inc. Trocar for use in deploying an anastomosis device and method of performing anastomosis
US6241758B1 (en) 1999-05-28 2001-06-05 Advanced Cardiovascular Systems, Inc. Self-expanding stent delivery system and method of use
US7153314B2 (en) 1999-06-22 2006-12-26 Ndo Surgical Tissue reconfiguration
US6488653B1 (en) 1999-08-12 2002-12-03 Wilson-Cook Medical Incorporated Dilation balloon having multiple diameters
US20050033327A1 (en) 1999-09-07 2005-02-10 John Gainor Retrievable septal defect closure device
US20080071301A1 (en) 1999-09-20 2008-03-20 Nuvasive, Inc. Annulotomy closure device and related methods
WO2001021247A1 (en) 1999-09-20 2001-03-29 Appriva Medical, Inc. Method and apparatus for closing a body lumen
US6746472B2 (en) 1999-09-20 2004-06-08 Ev3 Sunnyvale, Inc. Endoluminal anchor
US6436119B1 (en) 1999-09-30 2002-08-20 Raymedica, Inc. Adjustable surgical dilator
US6520908B1 (en) 1999-09-30 2003-02-18 Olympus Optical Co., Ltd. Electronic endoscope
US6669708B1 (en) 1999-12-09 2003-12-30 Michael Nissenbaum Devices, systems and methods for creating sutureless on-demand vascular anastomoses and hollow organ communication channels
US6475185B1 (en) 2000-02-24 2002-11-05 Scimed Life Systems, Inc. Occlusion device
US6682536B2 (en) 2000-03-22 2004-01-27 Advanced Stent Technologies, Inc. Guidewire introducer sheath
JP2001275947A (en) 2000-03-29 2001-10-09 Olympus Optical Co Ltd Puncture needle control tool for endoscope
US7204842B2 (en) 2000-05-10 2007-04-17 Boston Scientific Scimed, Inc. Devices and related methods for securing a tissue fold
US6921361B2 (en) 2000-07-24 2005-07-26 Olympus Corporation Endoscopic instrument for forming an artificial valve
US6348064B1 (en) 2000-09-01 2002-02-19 Angiolink Corporation Wound site management and wound closure device
US20030109900A1 (en) 2000-09-15 2003-06-12 Jonathan Martinek Knotless tissue anchor
US6736828B1 (en) 2000-09-29 2004-05-18 Scimed Life Systems, Inc. Method for performing endoluminal fundoplication and apparatus for use in the method
US6638213B2 (en) 2000-10-02 2003-10-28 Olympus Optical Co., Ltd. Endoscope
US6447524B1 (en) 2000-10-19 2002-09-10 Ethicon Endo-Surgery, Inc. Fastener for hernia mesh fixation
US6966917B1 (en) 2000-11-09 2005-11-22 Innovation Interventional Technologies B.V. Deformable connector for mechanically connecting hollow structures
US6614595B2 (en) 2001-02-16 2003-09-02 Olympus Optical Co., Ltd. Stereo endoscope
US7156857B2 (en) 2001-04-04 2007-01-02 Olympus Optical Co., Ltd. Endoscopic instruments
US6620122B2 (en) 2001-04-26 2003-09-16 Scimed Life Systems, Inc. Gastric pseudocyst drainage and stent delivery system for use therein
US6921387B2 (en) 2001-05-01 2005-07-26 Mayo Foundation For Medical Education And Research Vascular needle
US6535764B2 (en) 2001-05-01 2003-03-18 Intrapace, Inc. Gastric treatment and diagnosis device and method
US20040034371A1 (en) 2001-05-18 2004-02-19 Glen Lehman Method of promoting tissue adhesion
US6916332B2 (en) 2001-05-23 2005-07-12 Scimed Life Systems, Inc. Endoluminal fundoplication device and related method for installing tissue fastener
US20020183787A1 (en) 2001-06-01 2002-12-05 Velocimed, L.L.C. Closure devices, related delivery methods and tools, and related methods of use
US20020188301A1 (en) 2001-06-11 2002-12-12 Dallara Mark Douglas Tissue anchor insertion system
US20030120292A1 (en) 2001-06-20 2003-06-26 Park Medical, Llc Anastomotic device
US6645205B2 (en) 2001-08-15 2003-11-11 Core Medical, Inc. Apparatus and methods for reducing lung volume
US20030040803A1 (en) 2001-08-23 2003-02-27 Rioux Robert F. Maintaining an open passageway through a body lumen
WO2003020106A2 (en) 2001-08-28 2003-03-13 Ethicon, Inc. Composite staple for completing an anastomosis
US20030045893A1 (en) 2001-09-06 2003-03-06 Integrated Vascular Systems, Inc. Clip apparatus for closing septal defects and methods of use
US20030050665A1 (en) 2001-09-07 2003-03-13 Integrated Vascular Systems, Inc. Needle apparatus for closing septal defects and methods for using such apparatus
US20040049157A1 (en) * 2001-09-13 2004-03-11 Michael Plishka Paracentesis device having multiple detachable components
US20030088256A1 (en) 2001-10-03 2003-05-08 Conston Stanley R. Devices and methods for interconnecting vessels
EP1314404A2 (en) 2001-10-10 2003-05-28 Medico's Hirata Inc. Endoscopic transduodenal biliary drainage system
US20030069533A1 (en) 2001-10-10 2003-04-10 Hiroshi Kakutani Endoscopic transduodenal biliary drainage system
US20030073979A1 (en) 2001-10-15 2003-04-17 Wendy Naimark Medical device for delivering patches
US20040249985A1 (en) 2001-10-18 2004-12-09 Toshiaki Mori Host network interface device and drive network interface device
US7169161B2 (en) 2001-11-06 2007-01-30 Possis Medical, Inc. Guidewire having occlusive device and repeatably crimpable proximal end
US6942678B2 (en) 2001-11-06 2005-09-13 Possis Medical, Inc. Gas inflation/evacuation system and sealing system for guidewire assembly having occlusive device
US7150723B2 (en) 2001-11-29 2006-12-19 C-I-Medic Co., Ltd. Medical device including guide wire and balloon catheter for curing a coronary artery
US7182771B1 (en) 2001-12-20 2007-02-27 Russell A. Houser Vascular couplers, techniques, methods, and accessories
US6749621B2 (en) 2002-02-21 2004-06-15 Integrated Vascular Systems, Inc. Sheath apparatus and methods for delivering a closure device
WO2003071962A2 (en) 2002-02-25 2003-09-04 Yeung Jeffrey E Expandable fastener with compressive grips
US7077850B2 (en) 2002-05-01 2006-07-18 Scimed Life Systems, Inc. Tissue fastening devices and related insertion tools and methods
US7377897B1 (en) 2002-05-02 2008-05-27 Kunkel Sanford S Portal device
US20060111672A1 (en) 2002-05-28 2006-05-25 Mercator Medsystems, Inc. Methods and apparatus for aspiration and priming of inflatable structures in catheters
US20040073108A1 (en) 2002-05-29 2004-04-15 Zahid Saeed Device for directing a wire guide
US7998155B2 (en) 2002-06-20 2011-08-16 Tyco Healthcare Group Lp Method and apparatus for anastomosis including annular joining member
US20030236536A1 (en) 2002-06-20 2003-12-25 Scimed Life Systems, Inc. Endoscopic fundoplication devices and methods for treatment of gastroesophageal reflux disease
US6773440B2 (en) 2002-07-02 2004-08-10 Satiety, Inc. Method and device for use in tissue approximation and fixation
US20040019322A1 (en) 2002-07-23 2004-01-29 Hoffmann Gerard Von Intracranial aspiration catheter
US6902535B2 (en) 2002-08-26 2005-06-07 Kansey Nash Corporation Guide-wire mounted balloon modulation device and methods of use
US6835189B2 (en) 2002-10-15 2004-12-28 Scimed Life Systems, Inc. Controlled deployment balloon
US6974467B1 (en) 2002-11-04 2005-12-13 Gonzales Jr Antonio Method and apparatus for making a precise surgical incision
US20070213812A1 (en) 2002-11-15 2007-09-13 Webler William E Apparatuses and methods for delivering/deploying a medical device in a vessel
US6960233B1 (en) 2002-12-10 2005-11-01 Torax Medical, Inc. Methods and apparatus for improving the function of biological passages
US7416554B2 (en) 2002-12-11 2008-08-26 Usgi Medical Inc Apparatus and methods for forming and securing gastrointestinal tissue folds
US20060224183A1 (en) 2003-01-21 2006-10-05 Franz Freudenthal Implantable device
US20040243122A1 (en) 2003-02-13 2004-12-02 Coaptus Medical Corporation Transseptal closure of a patent foramen ovale and other cardiac defects
US7273451B2 (en) 2003-03-04 2007-09-25 Olympus Corporation Endoscopic treatment system and anastomotic method using this system
US20060167482A1 (en) 2003-04-04 2006-07-27 Swain Christopher P Device for transfixing and joining tissue
US20060200177A1 (en) 2003-04-16 2006-09-07 Tyco Healthcare Group Lp Method and apparatus for radical prostatectomy anastomosis including an anchor for engaging a body vessel and deployable sutures
US20040236346A1 (en) 2003-04-25 2004-11-25 Cook Incorporated Delivery catheter and method of manufacture
WO2005011463A2 (en) 2003-07-01 2005-02-10 Usgi Medical Inc. Methods and apparatus for gastric reduction
US20050059990A1 (en) 2003-07-31 2005-03-17 Ayala Juan Carlos System and method for introducing multiple medical devices
US20060217748A1 (en) 2003-09-30 2006-09-28 Ethicon Endo-Surgery, Inc. Method for Hybrid Gastro-Jejunostomy
US7309341B2 (en) 2003-09-30 2007-12-18 Ethicon Endo-Surgery, Inc. Single lumen anastomosis applier for self-deploying fastener
US20050075654A1 (en) 2003-10-06 2005-04-07 Brian Kelleher Methods and devices for soft tissue securement
US20050113868A1 (en) 2003-11-20 2005-05-26 Devellian Carol A. Device, with electrospun fabric, for a percutaneous transluminal procedure, and methods thereof
US20050187567A1 (en) 2004-02-20 2005-08-25 Esophyx, Inc. Tissue fixation devices and assemblies for deploying the same
US20060142790A1 (en) 2004-03-23 2006-06-29 Michael Gertner Methods and devices to facilitate connections between body lumens
WO2005096953A1 (en) 2004-03-31 2005-10-20 Wilson-Cook Medical Inc. Biopsy needle system
US20080243151A1 (en) 2004-04-12 2008-10-02 Binmoeller Kenneth F Luminal Structure Anchoring Devices and Methods
US20050228413A1 (en) 2004-04-12 2005-10-13 Binmoeller Kenneth F Automated transluminal tissue targeting and anchoring devices and methods
US20050251159A1 (en) 2004-05-07 2005-11-10 Usgi Medical Inc. Methods and apparatus for grasping and cinching tissue anchors
US20050251208A1 (en) 2004-05-07 2005-11-10 Usgi Medical Inc. Linear anchors for anchoring to tissue
US7361180B2 (en) 2004-05-07 2008-04-22 Usgi Medical, Inc. Apparatus for manipulating and securing tissue
US20070179426A1 (en) 2004-05-11 2007-08-02 Selden Nathan R Interfacial stent and method of maintaining patency of surgical fenestrations
US20050277981A1 (en) 2004-06-09 2005-12-15 Usgi Medical Inc. Apparatus and methods for optimizing anchoring force
US20060217762A1 (en) 2004-06-09 2006-09-28 Usgi Medical, Inc. Compressible tissue anchor assemblies
US7429264B2 (en) 2004-06-15 2008-09-30 Warsaw Orthopedic, Inc. Minimally invasive deployable cutting instrument
US20070197862A1 (en) 2004-06-18 2007-08-23 Jacques Deviere Endoscopic device
US20060062996A1 (en) 2004-09-22 2006-03-23 Yun-Chao Yeh Resin matrix composite with aluminum for lubrication in drilling
US7845536B2 (en) 2004-10-18 2010-12-07 Tyco Healthcare Group Lp Annular adhesive structure
US8187289B2 (en) 2004-11-05 2012-05-29 Ethicon Endo-Surgery, Inc. Device and method for the therapy of obesity
US20060116697A1 (en) 2004-11-30 2006-06-01 Esophyx, Inc. Flexible transoral endoscopic gastroesophageal flap valve restoration device and method
US20060142703A1 (en) 2004-12-07 2006-06-29 Cook Incorporated Catheter aperture with related structures and method
US20060190021A1 (en) 2005-02-18 2006-08-24 Michael Hausman Cutting device for subcutaneous incisions
US20060259074A1 (en) 2005-02-22 2006-11-16 Brian Kelleher Methods and devices for anchoring to soft tissue
US7942890B2 (en) 2005-03-15 2011-05-17 Tyco Healthcare Group Lp Anastomosis composite gasket
US20060259051A1 (en) 2005-04-08 2006-11-16 Alveolus, Inc. Duodenum stent and associated method
US7534247B2 (en) 2005-05-03 2009-05-19 Ethicon Endo-Surgery, Inc. Sheathless anastomotic ring applier device
US20070135825A1 (en) 2005-06-09 2007-06-14 Binmoeller Kenneth F Methods and devices for anchoring to tissue
US20060282087A1 (en) 2005-06-09 2006-12-14 Binmoeller Kenneth F Methods and devices for endosonography-guided fundopexy
US7591828B2 (en) 2005-07-22 2009-09-22 Ethicon Endo-Surgery, Inc. Resposable anastomotic ring applier device
US20100130993A1 (en) 2005-07-25 2010-05-27 Adrian Paz Anastomosis device and system
US20070027534A1 (en) 2005-07-27 2007-02-01 Bjarne Bergheim Methods and systems for cardiac valve delivery
US20070066863A1 (en) 2005-08-31 2007-03-22 Medtronic Vascular, Inc. Device for treating mitral valve regurgitation
US20070123934A1 (en) 2005-09-26 2007-05-31 Whisenant Brian K Delivery system for patent foramen ovale closure device
US20070123840A1 (en) 2005-10-18 2007-05-31 Usgi Medical, Inc. Instrument assisted abdominal access
US20090177288A1 (en) 2005-10-29 2009-07-09 Pnn Medical S.A. Stent for Use in a Tubular Organ of a Body
US20070112363A1 (en) 2005-11-15 2007-05-17 Endogastric Solutions, Inc. Apparatus including multiple invaginators for restoring a gastroesophageal flap valve and method
US20070123917A1 (en) 2005-11-29 2007-05-31 Ortiz Mark S Anastomotic device promoting tissue necrosis
US8034063B2 (en) 2007-07-13 2011-10-11 Xlumena, Inc. Methods and systems for treating hiatal hernias
US20090281379A1 (en) 2008-05-12 2009-11-12 Xlumena, Inc. System and method for transluminal access
US20090281557A1 (en) 2008-05-12 2009-11-12 Xlumena, Inc. Tissue anchor for securing tissue layers
US20100268029A1 (en) 2009-04-21 2010-10-21 Xlumena, Inc. Methods and apparatus for advancing a device from one body lumen to another
US20100268175A1 (en) 2009-04-21 2010-10-21 Xlumena, Inc. System and method for delivering expanding trocar through a sheath
US20110112622A1 (en) 2009-05-29 2011-05-12 Xlumena, Inc. Apparatus and method for deploying stent across adjacent tissue layers
US20110137394A1 (en) 2009-05-29 2011-06-09 Xlumena, Inc. Methods and systems for penetrating adjacent tissue layers
WO2012033760A1 (en) 2010-09-07 2012-03-15 Boston Scientific Scimed, Inc. Endoscopic ultrasound fine needle aspiration device
US20120109277A1 (en) 2010-10-25 2012-05-03 Keke Lepulu Apparatus and method for penetrating and enlarging adjacent tissue layers
US20120130417A1 (en) 2010-10-25 2012-05-24 Keke Lepulu Apparatus and method for penetrating and enlarging adjacent tissue layers

Non-Patent Citations (6)

* Cited by examiner, † Cited by third party
Title
Chopita et al.; Endoscopic gastroenteric anastomosis using magnets; Endoscopy; 37(4); pp. 313-317; Apr. 2005.
Fritscher-Ravens et al.; A through-the-scope device for suturing and tissue approximation under EUS control; Gastro Endo; 56(5); pp. 737-742; Nov. 2002.
Fritscher-Ravens et al.; Transgastric gastropexy and hiatal hernia repair for GERD under EUS control: A porcine model; Gastro Endo; 59(1); pp. 89-95; Jan. 2004.
International Search Report and Written Opinion of PCT Application No. PCT/US05/44158, mailed Apr. 14, 2008, 11 pages.
Phan et al.; U.S. Appl. No. 13/364,265 entitled "Apparatus and Method for Deploying Stent Across Adjacent Tissue Layers," filed Feb. 1, 2012.
Swain et al.; Knot tying at flexible endoscopy; gastro endo; 40(6); pp. 722-729; Nov. 1994.

Cited By (59)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10945735B2 (en) 2004-04-12 2021-03-16 Boston Scientific Scimed, Inc. Luminal structure anchoring devices and methods
US11857160B2 (en) 2004-04-12 2024-01-02 Boston Scientific Scimed, Inc. Luminal structure anchoring devices and methods
US8617196B2 (en) 2004-12-08 2013-12-31 Xlumena, Inc. Method and apparatus for performing needle guided interventions
US11925778B2 (en) 2005-07-06 2024-03-12 Vascular Pathways, Inc. Intravenous catheter insertion device
US10806906B2 (en) 2005-07-06 2020-10-20 Vascular Pathways, Inc. Intravenous catheter insertion device and method of use
US10912930B2 (en) 2005-07-06 2021-02-09 Vascular Pathways, Inc. Intravenous catheter insertion device and method of use
US10220191B2 (en) 2005-07-06 2019-03-05 Vascular Pathways, Inc. Intravenous catheter insertion device and method of use
US11020571B2 (en) 2005-07-06 2021-06-01 Vascular Pathways, Inc. Intravenous catheter insertion device and method of use
US11577054B2 (en) 2005-07-06 2023-02-14 Vascular Pathways, Inc. Intravenous catheter insertion device and method of use
US9675784B2 (en) 2007-04-18 2017-06-13 Vascular Pathways, Inc. Intravenous catheter insertion and blood sample devices and method of use
US9757540B2 (en) 2007-04-18 2017-09-12 Vascular Pathways, Inc. Intravenous catheter insertion and blood sample devices and method of use
US10525236B2 (en) 2007-05-07 2020-01-07 Vascular Pathways, Inc. Intravenous catheter insertion and blood sample devices and method of use
US10799680B2 (en) 2007-05-07 2020-10-13 Vascular Pathways, Inc. Intravenous catheter insertion and blood sample devices and method of use
US10086171B2 (en) 2007-05-07 2018-10-02 Vascular Pathways, Inc. Intravenous catheter insertion and blood sample devices and method of use
US10076330B2 (en) 2008-05-12 2018-09-18 Xlumena, Inc. Tissue anchor for securing tissue layers
US20100268029A1 (en) * 2009-04-21 2010-10-21 Xlumena, Inc. Methods and apparatus for advancing a device from one body lumen to another
US9381041B2 (en) 2009-04-21 2016-07-05 Xlumena, Inc. Methods and devices for access across adjacent tissue layers
US11135406B2 (en) 2010-05-14 2021-10-05 C. R. Bard, Inc. Catheter insertion device including top-mounted advancement components
US9950139B2 (en) 2010-05-14 2018-04-24 C. R. Bard, Inc. Catheter placement device including guidewire and catheter control elements
US10384039B2 (en) 2010-05-14 2019-08-20 C. R. Bard, Inc. Catheter insertion device including top-mounted advancement components
US11000678B2 (en) 2010-05-14 2021-05-11 C. R. Bard, Inc. Catheter placement device and method
US11278702B2 (en) 2010-05-14 2022-03-22 C. R. Bard, Inc. Guidewire extension system for a catheter placement device
US9872971B2 (en) 2010-05-14 2018-01-23 C. R. Bard, Inc. Guidewire extension system for a catheter placement device
US10688280B2 (en) 2010-05-14 2020-06-23 C. R. Bard, Inc. Catheter placement device including guidewire and catheter control elements
US10688281B2 (en) 2010-05-14 2020-06-23 C. R. Bard, Inc. Catheter placement device including guidewire and catheter control elements
US10722685B2 (en) 2010-05-14 2020-07-28 C. R. Bard, Inc. Catheter placement device including guidewire and catheter control elements
US11925779B2 (en) 2010-05-14 2024-03-12 C. R. Bard, Inc. Catheter insertion device including top-mounted advancement components
US11202886B2 (en) 2011-01-31 2021-12-21 Vascular Pathways, Inc. Intravenous catheter and insertion device with reduced blood spatter
US9616201B2 (en) 2011-01-31 2017-04-11 Vascular Pathways, Inc. Intravenous catheter and insertion device with reduced blood spatter
US10328239B2 (en) 2011-01-31 2019-06-25 Vascular Pathways, Inc. Intravenous catheter and insertion device with reduced blood spatter
US11123524B2 (en) 2011-02-25 2021-09-21 C. R. Bard, Inc. Medical component insertion device including a retractable needle
US9861792B2 (en) 2011-02-25 2018-01-09 C. R. Bard, Inc. Medical component insertion device including a retractable needle
USD903101S1 (en) 2011-05-13 2020-11-24 C. R. Bard, Inc. Catheter
US11317905B2 (en) * 2011-11-07 2022-05-03 C.R. Bard, Inc. Instruments for delivering transfascial sutures and methods of transfascial suturing
US9522254B2 (en) 2013-01-30 2016-12-20 Vascular Pathways, Inc. Systems and methods for venipuncture and catheter placement
US10265507B2 (en) 2013-01-30 2019-04-23 Vascular Pathways, Inc. Systems and methods for venipuncture and catheter placement
US10952732B2 (en) 2013-02-21 2021-03-23 Boston Scientific Scimed Inc. Devices and methods for forming an anastomosis
US20140276635A1 (en) * 2013-03-15 2014-09-18 Coloplast A/S Access sheath
US9925357B2 (en) * 2013-03-15 2018-03-27 Coloplast A/S Access sheath
US11565089B2 (en) 2014-09-05 2023-01-31 C. R. Bard, Inc. Catheter insertion device including retractable needle
US11033719B2 (en) 2014-09-05 2021-06-15 C. R. Bard, Inc. Catheter insertion device including retractable needle
US10232146B2 (en) 2014-09-05 2019-03-19 C. R. Bard, Inc. Catheter insertion device including retractable needle
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US11040176B2 (en) 2015-05-15 2021-06-22 C. R. Bard, Inc. Catheter placement device including an extensible needle safety component
US11759618B2 (en) 2016-09-12 2023-09-19 C. R. Bard, Inc. Blood control for a catheter insertion device
US10493262B2 (en) 2016-09-12 2019-12-03 C. R. Bard, Inc. Blood control for a catheter insertion device
US11400260B2 (en) 2017-03-01 2022-08-02 C. R. Bard, Inc. Catheter insertion device
US10561407B2 (en) 2017-05-05 2020-02-18 Hoya Corporation Apparatuses and methods for endoscopic tool joints
US11389626B2 (en) 2018-03-07 2022-07-19 Bard Access Systems, Inc. Guidewire advancement and blood flashback systems for a medical device insertion system
US20210000333A1 (en) * 2018-03-19 2021-01-07 Olympus Corporation Insertion assist device for endoscope and endoscope system
USD921884S1 (en) 2018-07-27 2021-06-08 Bard Access Systems, Inc. Catheter insertion device
US20200305685A1 (en) * 2019-03-27 2020-10-01 SPIRATION, INC., d/b/a OLYMPUS RESPIRATORY AMERICA User interface with dual-function control surface for positioning multiple components within a body
US11659980B2 (en) * 2019-03-27 2023-05-30 Gyrus Acmi, Inc. User interface with dual-function control surface for positioning multiple components within a body
US11559665B2 (en) 2019-08-19 2023-01-24 Becton, Dickinson And Company Midline catheter placement device
US11883615B2 (en) 2019-08-19 2024-01-30 Becton, Dickinson And Company Midline catheter placement device
US11576647B2 (en) * 2019-09-30 2023-02-14 Olympus Corporation Apparatus and method for performing interventional endoscopic ultrasound procedure
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JP5111112B2 (en) 2012-12-26
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US20090030380A1 (en) 2009-01-29
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US20130226218A1 (en) 2013-08-29
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US8617196B2 (en) 2013-12-31
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WO2006062996A3 (en) 2009-04-16

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